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. 2023 Nov 13;15(22):5396.
doi: 10.3390/cancers15225396.

Ultrasound Patterns of Hepatocellular Carcinoma and Their Prognostic Impact: A Retrospective Study

Chiara Barteselli  1 , Stefano Mazza  1 , Valentina Ravetta  1 , Francesca Torello Viera  1 , Letizia Veronese  1 , Chiara Frigerio  1 , Giulia Gori  2 , Gaetano Bergamaschi  3 , Carmelo Sgarlata  1 , Antonio Facciorusso  4 , Marcello Maestri  5 , Antonio Di Sabatino  2   3 , Andrea Anderloni  1
Affiliations

Ultrasound Patterns of Hepatocellular Carcinoma and Their Prognostic Impact: A Retrospective Study

Chiara Barteselli et al. Cancers (Basel). .

Abstract

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death. Abdominal ultrasound (US) is by far the most widely used first-level exam for the diagnosis of HCC. We aimed to assess whether different ultrasound patterns were related to tumor prognosis.

Methods: We retrospectively reviewed all patients with a new diagnosis of HCC (single nodule) and undergoing radiofrequency thermal ablation (RFTA) at our clinic between January 2009 and December 2021. Patients were classified according to four HCC ultrasound patterns: 1A, single capsulated nodule; 1B, well capsulated intra-node nodule; 1C, cluster consisting of capsulated nodules; and 2, non-capsulated nodule.

Results: 149 patients were analysed; median follow-up time was 43 months. US patterns 1A (32.9%) and 1B (61.1%) were the most commonly seen. Median overall survival (OS) and recurrence-free survival (RFS) from RFTA were 54 months (95% CI, 42-66) and 22 months (95% CI, 12-32), respectively. Pattern 1A showed the best OS. Compared to pattern 1A, 1B was independently associated with worse OS (51 months (95% CI, 34-68) vs. 46 months (95% CI, 18-62)) and RFS (34 months (95% CI, 27-41) vs. 18 months (95% CI, 12-24)). Patterns 1C and 2 were associated with worse RFS compared to 1A, while no difference was seen for OS. Among baseline clinical variables, pattern 1B exhibited higher histological grade (p = 0.048) and tumor dimension (p = 0.034) compared to pattern 1A.

Conclusions: Our findings demonstrate that different US patterns correlate with different survival outcomes and tumor behavior in patients with HCC. Prospective studies are needed to confirm these results.

Keywords: abdominal ultrasound; hepatocellular carcinoma; histological grade; overall survival; recurrence-free survival; ultrasound pattern.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Illustrative images of hepatocellular carcinoma nodules divided into the four ultrasound patterns, with the relevant macroscopic appearance showed below. (1A)—single, capsulated nodule; (1B)—intra-node node, well capsulated; (1C)—cluster formation consisting of capsulated nodules; and (2)—non-capsulated.
Figure 2
Figure 2
Kaplan-Mejer curve for overall survival. Time expressed in months.
Figure 3
Figure 3
Kaplan-Mejer curves for overall survival and recurrence-free survival stratified by ultrasound patterns. (a) Overall survival; (b) Recurrence-free survival.
Figure 4
Figure 4
Box plot graph showing the distribution of nodule sizes according to US pattern 1A or 1B.
See this image and copyright information in PMC

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