MRI imaging features for predicting macrotrabecular-massive subtype hepatocellular carcinoma: A systematic review and meta-analysis Review
| Authors: | Kim, T. H.; Woo, S.; Lee, D. H.; Do, R. K.; Chernyak, V. |
| Review Title: | MRI imaging features for predicting macrotrabecular-massive subtype hepatocellular carcinoma: A systematic review and meta-analysis |
| Abstract: | Purpose: To identify significant MRI features associated with macrotrabecular-massive hepatocellular carcinoma (MTM-HCC), and to assess the distribution of Liver Imaging Radiology and Data System (LI-RADS, LR) category assignments. Methods: PubMed and EMBASE were searched up to March 28, 2023. Random-effects model was constructed to calculate pooled diagnostic odds ratios (DORs) and 95% confidence intervals (CIs) for each MRI feature for differentiating MTM-HCC from NMTM-HCC. The pooled proportions of LI-RADS category assignments in MTM-HCC and NMTM-HCC were compared using z-test. Results: Ten studies included 1978 patients with 2031 HCCs (426 (20.9%) MTM-HCC and 1605 (79.1%) NMTM-HCC). Six MRI features showed significant association with MTM-HCC: tumor in vein (TIV) (DOR = 2.4 [95% CI, 1.6–3.5]), rim arterial phase hyperenhancement (DOR =2.6 [95% CI, 1.4–5.0]), corona enhancement (DOR = 2.6 [95% CI, 1.4–4.5]), intratumoral arteries (DOR = 2.6 [95% CI, 1.1–6.3]), peritumoral hypointensity on hepatobiliary phase (DOR = 2.2 [95% CI, 1.5–3.3]), and necrosis (DOR = 4.2 [95% CI, 2.0–8.5]). The pooled proportions of LI-RADS categories in MTM-HCC were LR-3, 0% [95% CI, 0–2%]; LR-4, 11% [95% CI, 6–16%]; LR-5, 63% [95% CI, 55–71%]; LR-M, 12% [95% CI, 6–19%]; and LR-TIV, 13% [95% CI, 6–22%]. In NMTM-HCC, the pooled proportions of LI-RADS categories were LR-3, 1% [95% CI, 0–2%]; LR-4, 8% [95% CI, 3–15%]; LR-5, 77% [95% CI, 71–82%]; LR-M, 5% [95% CI, 3–7%]; and LR-TIV, 6% [95% CI, 2–11%]. MTM-HCC had significantly lower proportion of LR-5 and higher proportion of LR-M and LR-TIV categories. Conclusions: Six MRI features showed significant association with MTM-HCC. Additionally, compared to NMTM-HCC, MTM-HCC are more likely to be categorized LR-M and LR-TIV and less likely to be categorized LR-5. Clinical relevance statement: Several MR imaging features can suggest macrotrabecular-massive hepatocellular carcinoma subtype, which can assist in guiding treatment plans and identifying potential candidates for clinical trials of new treatment strategies. Key Points: • Macrotrabecular-massive hepatocellular carcinoma is a subtype of HCC characterized by its aggressive nature and unfavorable prognosis. • Tumor in vein, rim arterial phase hyperenhancement, corona enhancement, intratumoral arteries, peritumoral hypointensity on hepatobiliary phase, and necrosis on MRI are indicative of macrotrabecular-massive hepatocellular carcinoma. • Various MRI characteristics can be utilized for the diagnosis of the macrotrabecular-massive hepatocellular carcinoma subtype. This can prove beneficial in guiding treatment decisions and identifying potential candidates for clinical trials involving novel treatment approaches. © The Author(s), under exclusive licence to European Society of Radiology 2024. |
| Keywords: | cancer surgery; clinical feature; liver cell carcinoma; liver transplantation; carcinoma, hepatocellular; liver neoplasms; cancer patient; comparative study; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer diagnosis; tumor differentiation; cohort analysis; pathology; diagnostic imaging; retrospective study; publication; prediction; liver; image enhancement; systematic review; liver tumor; medline; hepatectomy; meta analysis; mri; systemic circulation; meta-analysis; embase; nuclear magnetic resonance imaging agent; tumor necrosis; radiological parameters; artery; procedures; oncological parameters; humans; human; male; female; article; liver imaging reporting and data system; liver imaging and radiology and data system; macrotrabecular-massive hepatocellular carcinoma; corona enhancement; coronal parameter; intratumoral artery; macrotrabecular massive hepatocellular carcinoma; non macrotrabecular massive hepatocellular carcinoma; peritumoral hypointensity onhepatobiliary phase; rim arterial phase hyperenhancement; tumor in vein |
| Journal Title: | European Radiology |
| Volume: | 34 |
| Issue: | 10 |
| ISSN: | 0938-7994 |
| Publisher: | Springer |
| Date Published: | 2024-10-01 |
| Start Page: | 6896 |
| End Page: | 6907 |
| Language: | English |
| DOI: | 10.1007/s00330-024-10671-1 |
| PUBMED: | 38507054 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Victoria Chernyak -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work