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KMID : 1040620190250040390
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Clinical and Molecular Hepatology
2019 Volume.25 No. 4 p.390 ~ p.399
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Risk assessment of hepatocellular carcinoma development for indeterminate hepatic nodules in patients with chronic hepatitis B
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Shin Haneulsaem
Jung Yeon-Woo
Kim Beom-Kyung
Park Jun-Yong
Kim Do-Young
Ahn Sang-Hoon
Han Kwang-Hyub
Kim Yeun-Yoon
Choi Jin-Young
Kim Seung-Up
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Abstract
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Background/Aims: A risk prediction model for the development of hepatocellular carcinoma (HCC) from indeterminate nodules detected on computed tomography (CT) (RadCT score) in patients with chronic hepatitis B (CHB)-related cirrhosis was proposed. We validated this model for indeterminate nodules on magnetic resonance imaging (MRI).
Methods: Between 2013 and 2016, Liver Imaging Reporting and Data System (LI-RADS) 2/3 nodules on MRI were detected in 99 patients with CHB. The RadCT score was calculated.
Results: The median age of the 72 male and 27 female subjects was 58 years. HCC history and liver cirrhosis were found in 47 (47.5%) and 44 (44.4%) patients, respectively. The median RadCT score was 112. The patients with HCC (n=41, 41.4%) showed significantly higher RadCT scores than those without (median, 119 vs. 107; P=0.013); the Chinese university-HCC and risk estimation for HCC in CHB (REACH-B) scores were similar (both P>0.05). Arterial enhancement, T2 hyperintensity, and diffusion restriction on MRI were not significantly different in the univariate analysis (all P>0.05); only the RadCT score significantly predicted HCC (hazard ratio [HR]=1.018; P=0.007). Multivariate analysis showed HCC history was the only independent HCC predictor (HR=2.374; P=0.012). When the subjects were stratified into three risk groups based on the RadCT score (<60, 60?105, and >105), the cumulative HCC incidence was not significantly different among them (all P>0.05, log-rank test).
Conclusions: HCC history, but not RadCT score, predicted CHB-related HCC development from LI-RADS 2/3 nodules. New risk models optimized for MRI-defined indeterminate nodules are required.
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KEYWORD
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Radiographic image interpretation, Computer-assisted, Liver neoplasms, Hepatitis B, Risk assessment, Hepatocellular carcinoma
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