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• Clinical Article •
Risk prediction and prognostic evaluation of hepatocellular carcinoma CK19 expression based on LI-RADS v2018 and other MRI features
LU Mengtian  QU Qi  XU Lei  ZHANG Jiyun  LIU Maotong  JIANG Jifeng  ZHANG Tao  ZHANG Xueqin 

Cite this article as: LU M T, QU Q, XU L, et al. Risk prediction and prognostic evaluation of hepatocellular carcinoma CK19 expression based on LI-RADS v2018 and other MRI features[J]. Chin J Magn Reson Imaging, 2024, 15(3): 107-113, 121. DOI:10.12015/issn.1674-8034.2024.03.018.


[Abstract] Objective To investigate the value of the Liver Imaging Reporting and Data System version 2018 (LI-RADS v2018) in preoperative predicting the expression of cytokeratin 19 (CK19) and assessing postoperative prognosis in hepatocellular carcinoma (HCC).Matirials and Methods: Two hundred and twenty patients with pathologically-confirmed HCC were retrospectively included who underwent preoperative MRI examination, including 59 cases with CK19-positive expression and 161 cases with CK19-negative expression. All patients were divided into training and validation sets in a 7∶3 ratio, and the clinical, pathological, and imaging data of the patients were analyzed. Independent predictors for CK19 expression in HCC were determined by univariate- and multivariate logistic regression analysis and a nomogram scoring model was constructed. The diagnostic performance of the model was assessed using receiver operating characteristic (ROC) curve analysis. Calibration curves and decision curves were plotted to evaluate the calibration performance and clinical applicability of the model. Nomogram scores for patients were calculated and used for high and low risk stratification. The Kaplan-Meier survival curve was employed to compare the overall, early, and late recurrence-free survival rates among different subgroups.Results Corona enhancement (OR=3.432, P=0.045), rim arterial phase hyperenhancement (OR=32.073, P=0.017), targetoid diffusion restriction (OR=12.941, P=0.006), irregular tumor margin (OR=4.590, P=0.014), and relative enhancement ratio (RER) in the hepatobiliary phase (OR=0.014, P=0.023) were independent predictors for CK19 expression in HCC. The AUC of the prediction model in the training set and validation set were 0.884 (95% CI: 0.823-0.930) and 0.748 (95% CI: 0.625-0.846), respectively. The calibration curve and decision curve showed that the calibration performance and clinical applicability of the model were good. Significant differences were observed in overall recurrence-free survival rates between the CK19-positive and CK19-negative groups, as well as in overall, early and late recurrence free survival rates between high and low-risk groups (P<0.05).Conclusions Corona enhancement, rim arterial phase hyperenhancement, and targetoid diffusion restriction, combined with irregular tumor margin and enhancement quantitative parameter in hepatobiliary phase can achieve preoperative risk prediction of CK19 expression in HCC, which also aids in assessing HCC postoperative recurrence.
[Keywords] primary hepatocellular carcinoma；cytokeratin 19；prediction model；Liver Imaging Reporting and Data System；magnetic resonance imaging

LU Mengtian1, 2   QU Qi1, 2   XU Lei2   ZHANG Jiyun2   LIU Maotong2   JIANG Jifeng2   ZHANG Tao2   ZHANG Xueqin2*  

1 Nantong University, Nantong 226006, China

2 Department of Radiology, Nantong Third People's Hospital, Nantong 226006, China

Corresponding author: ZHANG X Q, E-mail: 13962981245@163.com

Conflicts of interest   None.

Received  2023-11-26
Accepted  2024-02-26
DOI: 10.12015/issn.1674-8034.2024.03.018
Cite this article as: LU M T, QU Q, XU L, et al. Risk prediction and prognostic evaluation of hepatocellular carcinoma CK19 expression based on LI-RADS v2018 and other MRI features[J]. Chin J Magn Reson Imaging, 2024, 15(3): 107-113, 121. DOI:10.12015/issn.1674-8034.2024.03.018.

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