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• Clinical Article •
Evaluation and prediction of therapeutic effect of hepatocellular carcinoma after TACE based on contrast enhanced MRI histogram analysis
WANG Dongdong  LI Xiaoming  YANG Liu  ZHANG Sijia 

Cite this article as: WANG D D, LI X M, YANG L, et al. Evaluation and prediction of therapeutic effect of hepatocellular carcinoma after TACE based on contrast enhanced MRI histogram analysis[J]. Chin J Magn Reson Imaging, 2024, 15(1): 113-118, 131. DOI:10.12015/issn.1674-8034.2024.01.018.


[Abstract] Objective To evaluate and predict the early curative effect of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma based on contrast-enhanced magnetic resonance imaging (CE-MRI) histogram parameters of MRI.Materials and Methods Sixty-four patients with hepatocellular carcinoma confirmed by pathological biopsy or clinically diagnosed from June 2018 to December 2021 were selected for study. All patients underwent routine MR scan and multi-phase dynamic enhanced T1WI contrast-enhanced scan within 1 month before TACE treatment and 4-6 weeks after the first TACE treatment. According to the modified solid tumor efficacy evaluation criteria (mRECIST), the patients were divided into effective group of 34 cases and ineffective group of 30 cases. The HCC maximum axial T1WI images (arterial phase, portal phase and delayed phase) of HCC maximum slice images were selected for all patients, and the histogram features of the lesions were manually extracted by sketching ROI with MaZda software, including mean, variance, skewness, kurtosis and the values of the 1st, 10th, 50th, 90th and 99th percentiles (recorded as Perc1, Perc10, Pere50, Perc90 and Perc99, respectively). Statistical software was used to compare the differences of histogram parameters between effective group and ineffective group before and after TACE treatment. The parameters with statistical differences in the postoperative efficacy of HCC were evaluated by the receiver operating characteristic (ROC) curve, and the valuable parameter values and thresholds were obtained.Results The parameters with statistically significant differences between the two groups before TACE treatment including mean value, Perc50, Perc90, Perc99 in arterial phase, Perc1 in venous phase, and peak value in delayed phase (P<0.05); the parameters with statistically significant differences between the two groups after TACE treatment including the mean value of delay period, Perc50, Perc99 (P<0.05); there was no statistically significant difference in the other parameters between the two groups before and after TACE treatment (P>0.05). The ROC curve results showed that the efficacy of each parameter was as follows: preTACE arterial phase mean>postTACE delay phase Perc99>preTACE arterial phase Perc90>postTACE delay phase mean>preTACE delay phase kurtosis>postTACE delay phase Perc50>pretTACE delay phase Perc50>preTACE arterial phase Perc99. The area under the ROC curve of preTACE arterial phase mean was the highest, with a value of 0.710 (95% CI: 0.583-0.817).Conclusions The histogram features of CE-MRI can effectively evaluate and predict the characteristics of early curative effect after TACE of hepatocellular carcinoma, which helps guide clinical treatment plans.
[Keywords] hepatocellular carcinoma；magnetic resonance imaging；contrast enhanced magnetic resonance imaging；histogram analysis；texture analysis

WANG Dongdong   LI Xiaoming   YANG Liu   ZHANG Sijia*  

Department of Radiology, the Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou 450053, China

Corresponding author: ZHANG S J, E-mail: 13703923296@163.com

Conflicts of interest   None.

Received  2023-06-07
Accepted  2023-12-26
DOI: 10.12015/issn.1674-8034.2024.01.018
Cite this article as: WANG D D, LI X M, YANG L, et al. Evaluation and prediction of therapeutic effect of hepatocellular carcinoma after TACE based on contrast enhanced MRI histogram analysis[J]. Chin J Magn Reson Imaging, 2024, 15(1): 113-118, 131. DOI:10.12015/issn.1674-8034.2024.01.018.

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