Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography

Abstract Background To investigate the potential value of volumetric iodine quantification using preoperative dual-energy computed tomography (DECT) for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods This retrospective study included patients with single HCC treat...

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Main Authors: Taek Min Kim, Jeong Min Lee, Jeong Hee Yoon, Ijin Joo, Sae-Jin Park, Sun Kyung Jeon, Bernhard Schmidt, Sedlmair Martin
Format: Article
Language:English
Published: BMC 2020-08-01
Series:Cancer Imaging
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40644-020-00338-7
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author Taek Min Kim
Jeong Min Lee
Jeong Hee Yoon
Ijin Joo
Sae-Jin Park
Sun Kyung Jeon
Bernhard Schmidt
Sedlmair Martin
author_facet Taek Min Kim
Jeong Min Lee
Jeong Hee Yoon
Ijin Joo
Sae-Jin Park
Sun Kyung Jeon
Bernhard Schmidt
Sedlmair Martin
author_sort Taek Min Kim
collection DOAJ
description Abstract Background To investigate the potential value of volumetric iodine quantification using preoperative dual-energy computed tomography (DECT) for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods This retrospective study included patients with single HCC treated through surgical resection who underwent preoperative DECT. Quantitative DECT features, including normalized iodine concentration (NIC) to the aorta and mixed-energy CT attenuation value in the arterial phase, were three-dimensionally measured for peritumoral and intratumoral regions: (i) layer-by-layer analysis for peritumoral layers (outer layers 1 and 2; numbered in close order from the tumor boundary) and intratumoral layers (inner layers 1 and 2) with 2-mm layer thickness and (ii) volume of interest (VOI)-based analysis with different volume coverage (tumor itself; VOIO1, tumor plus outer layer 1; VOIO2, tumor plus outer layers 1 and 2; VOII1, tumor minus inner layer 1; VOII2, tumor minus inner layers 1 and 2). In addition, qualitative CT features, including peritumoral enhancement and tumor margin, were assessed. Qualitative and quantitative CT features were compared between HCC patients with and without MVI. Diagnostic performance of DECT parameters of layers and VOIs was assessed using receiver operating characteristic curve analysis. Results A total of 36 patients (24 men, mean age 59.9 ± 8.5 years) with MVI (n = 14) and without MVI (n = 22) were included. HCCs with MVI showed significantly higher NICs of outer layer 1, outer layer 2, VOIO1, and VOIO2 than those without MVI (P = 0.01, 0.04, 0.02, 0.02, respectively). Among the NICs of layers and VOIs, the highest area under the curve was obtained in outer layer 1 (0.747). Qualitative features, including peritumoral enhancement and tumor margin, and the mean CT attenuation of each layer and each VOI were not significantly different between HCCs with and without MVI (both P >  0.05). Conclusions Volumetric iodine quantification of peritumoral and intratumoral regions in arterial phase using DECT may help predict the MVI of HCC.
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spelling doaj.art-5012190cd7ad4c2586a1c133e3eb0a242022-12-21T18:59:43ZengBMCCancer Imaging1470-73302020-08-0120111110.1186/s40644-020-00338-7Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomographyTaek Min Kim0Jeong Min Lee1Jeong Hee Yoon2Ijin Joo3Sae-Jin Park4Sun Kyung Jeon5Bernhard Schmidt6Sedlmair Martin7Department of Radiology, Seoul National University HospitalDepartment of Radiology, Seoul National University HospitalDepartment of Radiology, Seoul National University HospitalDepartment of Radiology, Seoul National University HospitalDepartment of Radiology, Seoul National University HospitalDepartment of Radiology, Seoul National University HospitalResearch and development department, Siemens HealthineersResearch and development department, Siemens HealthineersAbstract Background To investigate the potential value of volumetric iodine quantification using preoperative dual-energy computed tomography (DECT) for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods This retrospective study included patients with single HCC treated through surgical resection who underwent preoperative DECT. Quantitative DECT features, including normalized iodine concentration (NIC) to the aorta and mixed-energy CT attenuation value in the arterial phase, were three-dimensionally measured for peritumoral and intratumoral regions: (i) layer-by-layer analysis for peritumoral layers (outer layers 1 and 2; numbered in close order from the tumor boundary) and intratumoral layers (inner layers 1 and 2) with 2-mm layer thickness and (ii) volume of interest (VOI)-based analysis with different volume coverage (tumor itself; VOIO1, tumor plus outer layer 1; VOIO2, tumor plus outer layers 1 and 2; VOII1, tumor minus inner layer 1; VOII2, tumor minus inner layers 1 and 2). In addition, qualitative CT features, including peritumoral enhancement and tumor margin, were assessed. Qualitative and quantitative CT features were compared between HCC patients with and without MVI. Diagnostic performance of DECT parameters of layers and VOIs was assessed using receiver operating characteristic curve analysis. Results A total of 36 patients (24 men, mean age 59.9 ± 8.5 years) with MVI (n = 14) and without MVI (n = 22) were included. HCCs with MVI showed significantly higher NICs of outer layer 1, outer layer 2, VOIO1, and VOIO2 than those without MVI (P = 0.01, 0.04, 0.02, 0.02, respectively). Among the NICs of layers and VOIs, the highest area under the curve was obtained in outer layer 1 (0.747). Qualitative features, including peritumoral enhancement and tumor margin, and the mean CT attenuation of each layer and each VOI were not significantly different between HCCs with and without MVI (both P >  0.05). Conclusions Volumetric iodine quantification of peritumoral and intratumoral regions in arterial phase using DECT may help predict the MVI of HCC.http://link.springer.com/article/10.1186/s40644-020-00338-7Hepatocellular carcinomaMicrovascular invasionDual-energy CTPeritumoral enhancementIodine quantificationIodine concentration
spellingShingle Taek Min Kim
Jeong Min Lee
Jeong Hee Yoon
Ijin Joo
Sae-Jin Park
Sun Kyung Jeon
Bernhard Schmidt
Sedlmair Martin
Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
Cancer Imaging
Hepatocellular carcinoma
Microvascular invasion
Dual-energy CT
Peritumoral enhancement
Iodine quantification
Iodine concentration
title Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
title_full Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
title_fullStr Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
title_full_unstemmed Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
title_short Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
title_sort prediction of microvascular invasion of hepatocellular carcinoma value of volumetric iodine quantification using preoperative dual energy computed tomography
topic Hepatocellular carcinoma
Microvascular invasion
Dual-energy CT
Peritumoral enhancement
Iodine quantification
Iodine concentration
url http://link.springer.com/article/10.1186/s40644-020-00338-7
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