Preoperative normalized iodine concentration derived from spectral CT is correlated with early recurrence of hepatocellu
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ONCOLOGY
Preoperative normalized iodine concentration derived from spectral CT is correlated with early recurrence of hepatocellular carcinoma after curative resection Ningbin Luo 1,2,3,4 & Wenzhu Li 5 & Jisheng Xie 1,2,3,4 & Danhui Fu 1,2,3,4 & Lidong Liu 1,2,3,4 & Xiangyang Huang 1,2,3,4 & Danke Su 1,2,3,4 & Guanqiao Jin 1,2,3,4 Received: 5 May 2020 / Revised: 10 August 2020 / Accepted: 21 September 2020 # European Society of Radiology 2020
Abstract Objectives To investigate whether normalized iodine concentration (NIC) correlates with tumor microvessel density and early recurrence in patients with HCC. Materials and methods We included 71 patients with surgically resected single HCC in this prospective study who underwent preoperative spectral CT between November 2014 and June 2016. Two observers independently measured the NIC in the arterial phase (AP) and portal venous phase (PVP). The relationship between NIC and microvessel density was evaluated. Univariate and multivariate logistic regression was performed to evaluate independent predictors of early recurrence. Results Early recurrence occurred in 28 of 71 patients (39.4%) during the 2-year follow-up. NIC-AP positively correlated with microvessel density for the two observers (r = 0.593 and 0.527). Based on multivariate analysis, independent risk factors for early HCC recurrence were tumor size (odds ratio, 1.200; p = 0.043) and NIC-AP (odds ratio, 2.522; p = 0.005). For the two observers, areas under the receiver operating characteristic curve for predicting early HCC recurrence were 0.719 and 0.677. Early recurrence rates were significantly higher among patients with NIC-AP values higher than the optimal cutoff than among those with values below the cutoff. Conclusion Normalized iodine concentration in the arterial phase from spectral CT reflects tumor-derived angiogenesis and is a potential predictive biomarker for early recurrence of hepatocellular carcinoma. Key Points • Normalized iodine concentration in the arterial phase positively correlated with microvessel density of hepatocellular carcinoma. • In the patients with hepatocellular carcinoma, tumor size and normalized iodine concentration in the arterial phase were independent risk factors for early hepatocellular carcinoma recurrence. • Early hepatocellular carcinoma recurrence rates were significantly higher when normalized iodine concentration in the arterial phase values was above the optimal cutoff. Keywords Tomography, X-ray computed . Neovascularization, Pathologic . Hepatocellular carcinoma . Surgery . Treatment outcome Ningbin Luo and Wenzhu Li contributed equally to this work * Danke Su [email protected]
3
Department of Radiology, Guangxi Key Clinical Specialties, 71 Hedi Road, Nanning, Guangxi, People’s Republic of China
* Guanqiao Jin [email protected]
4
Department of Radiology, Guangxi Medical University Cancer Hospital Superiority Cultivation Discipline, 71 Hedi Road, Nanning, Guangxi, People’s Republic of China
1
Department of Radiology, Guangxi Medical University Cancer Hospit
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