The nVR model: prediction of LI-RADS treatment response nonviable recurrence of hepatocellular carcinoma after primary transarterial chemoembolization.

IF 2.2 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2025-04-11 DOI:10.1007/s00261-025-04924-w

Shuhang Zhang, Weilang Wang, Xiuming Zhang, Binyan Zhong, Feng Feng, Wu Cai, Binrong Li, Varsha Ajith Menon, Shuwei Zhou, Teng Zhang, Xunjun Chen, Shenghong Ju, Yuan-Cheng Wang

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引用次数: 0

Abstract

Objectives: This study aims to build a prediction model based on MRI features and clinical characteristics for early tumor recurrence (< 12 months) in lesions which evaluated as LR-TR nonviable at first follow up (1-2 months) after transaterial chemoembolization (TACE).

Methods: This multicenter retrospective study included consecutive patients with hepatocellular carcinoma (HCC) who underwent initial TACE from five centers between February 2015 and October 2022. Additionally, patients from a completed clinical trial (NCT03113955) were also included for this retrospective analysis. Nineteen baseline imaging features and six first follow-up imaging features were evaluated for lesions classified as LR-TR nonviable at the first post-TACE imaging assessment. A predictive model integrating clinical and MRI features for early recurrence of LR-TR nonviable lesions was developed with logistic regression analyses and validated on a 5-fold cross-validation. The model's performance was further validated by analyzing relapse-free survival (RFS) using Kaplan-Meier curves.

Results: Non-smooth margin (OR: 4.69; 95% CI: 1.91, 11.56; P = 0.001) and peritumoral hyperintensity on T2-weighted imaging or diffusion-weighted imaging (OR: 6.12; 95% CI: 2.53, 14.80; P < 0.001) were identified as independent risk factors for early recurrence of LR-TR nonviable lesions. The non-Viable Recurrence (nVR) model, developed using these two features, achieved area under the receiver operating characteristic curve of 0.759 (0.734, 0.784) in the training cohort and 0.765 (0.632, 0.898) in the validation cohort. Patients were stratified into high-risk and low-risk groups based on the Youden index, with RFS significantly differing between these groups in both the training (P < 0.001) and validation cohorts (P = 0.009).

Conclusion: Based on two radiologic features, the nVR model has demonstrated relatively reliable efficacy in predicting early post-TACE recurrence.

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nVR模型：预测LI-RADS治疗对原发性经动脉化疗栓塞后肝癌不可存活复发的疗效。

目的：本研究旨在建立基于MRI特征和临床特征的早期肿瘤复发预测模型(方法：本多中心回顾性研究纳入了2015年2月至2022年10月间5个中心连续接受初始TACE治疗的肝细胞癌（HCC）患者。此外，来自一项完成的临床试验（NCT03113955）的患者也被纳入该回顾性分析。在tace后第一次影像学评估中，19个基线影像学特征和6个首次随访影像学特征被归类为LR-TR不可活的病变。通过逻辑回归分析，建立了一个综合临床和MRI特征的预测模型，用于预测LR-TR不可存活病变的早期复发，并通过5倍交叉验证进行了验证。通过Kaplan-Meier曲线分析无复发生存期（RFS）进一步验证了模型的性能。结果：边缘不光滑(OR: 4.69；95% ci: 1.91, 11.56；P = 0.001)和肿瘤周围t2加权成像或弥散加权成像的高信号(or: 6.12；95% ci: 2.53, 14.80；结论：基于两个影像学特征，nVR模型在预测tace术后早期复发方面具有相对可靠的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits