| Abstract: |
Objectives: Various mutations in hepatocellular carcinoma (HCC) carry prognostic implications. The objective of this study is to assess CT and MRI imaging features associated with Catenin Beta-1 (CTNNB1) mutation in HCC. Methods: This retrospective, IRB- approved multi-reader, single-center study included treatment-naive, pathologic-proven HCC that underwent contrast-enhanced CT, MRI or both, with subsequent targeted tumor sequencing test. Preoperative CT and MRI were reviewed for the Liver Imaging Reporting and Data System (LI-RADS, LR) features and prognostic imaging features. Fisher’s exact test and multiple testing adjustment were used to assess the association of imaging features and CTNNB1 mutation status. Results: Of the 160 HCCs included (median age 69 [IQR: 62, 75], 125 men), 58 (36%) had CTNNB1 mutation. Compared to wildtype, CTNNB1-mutated HCCs were more likely to be present as solitary lesion (CT: 26/43[60%] vs. 31/80 [40%], p = 0.024), have mosaic appearance (MRI: 9/34[26%] vs. 3/68[4.4%], p = 0.002), blood products in mass (CT: 7/43[16%] vs. 2/80[2.5%], p = 0.009; MRI: 12/34[35%] vs. 8/68[12%], p = 0.008), necrosis (CT: 16/43[37%] vs. 14/80[18]%, p = 0.026), intralesional arteries (CT: 26/43[60%] vs. 32/80[40%], p = 0.038). A subgroup of 98 high risk patients (hepatitis B, morphologic cirrhosis) were assigned LI-RADS categorization; majority of patients were assigned LR-5 (CT: 15/25[60%] vs. 21/52[40%]; MRI: 10/18[56%] vs. 19/44[43%]). No feature was significantly associated with CTNNB1 mutation status after multiple testing adjustment. Conclusion: Compared to wildtype, CTNNB1-mutated HCCs are more likely to appear as solitary masses with mosaic, heterogeneous appearance containing blood products, necrosis and intralesional arteries. Majority of CTNNB1-mutated tumors were categorized as LR-5 in a subgroup of high risk patients. No imaging feature independently predicted CTNNB1-mutated HCCs. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025. |
