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Published in: Abdominal Radiology 6/2017

01-06-2017

CT-based radiomics signature: a potential biomarker for preoperative prediction of early recurrence in hepatocellular carcinoma

Authors: Ying Zhou, Lan He, Yanqi Huang, Shuting Chen, Penqi Wu, Weitao Ye, Zaiyi Liu, Changhong Liang

Published in: Abdominal Radiology | Issue 6/2017

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Abstract

Purpose

To develop a CT-based radiomics signature and assess its ability for preoperatively predicting the early recurrence (≤1 year) of hepatocellular carcinoma (HCC).

Methods

A total of 215 HCC patients who underwent partial hepatectomy were enrolled in this retrospective study, and all the patients were followed up at least within 1 year. Radiomics features were extracted from arterial- and portal venous-phase CT images, and a radiomics signature was built by the least absolute shrinkage and selection operator (LASSO) logistic regression model. Preoperative clinical factors associated with early recurrence were evaluated. A radiomics signature, a clinical model, and a combined model were built, and the area under the curve (AUC) of operating characteristics (ROC) was used to explore their performance to discriminate early recurrence.

Results

Twenty-one radiomics features were chosen from 300 candidate features to build a radiomics signature that was significantly associated with early recurrence (P < 0.001), and they presented good performance in the discrimination of early recurrence alone with an AUC of 0.817 (95% CI: 0.758–0.866), sensitivity of 0.794, and specificity of 0.699. The AUCs of the clinical and combined models were 0.781 (95% CI: 0.719–0.834) and 0.836 (95% CI: 0.779–0.883), respectively, with the sensitivity being 0.784 and 0.824, and the specificity being 0.619 and 0.708, respectively. Adding a radiomics signature into conventional clinical variables can significantly improve the accuracy of the preoperative model in predicting early recurrence (P = 0.01).

Conclusions

The radiomics signature was a significant predictor for early recurrence in HCC. Incorporating radiomics signature into conventional clinical factors performed better for preoperative estimation of early recurrence than with clinical variables alone.
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Literature
5.
go back to reference Torzilli G, Donadon M, Marconi M, et al. (2008) Hepatectomy for stage B and stage C hepatocellular carcinoma in the Barcelona Clinic Liver Cancer classification: results of a prospective analysis. Archiv Surg (Chicago, IL: 1960) 143(11):1082–1090. doi:10.1001/archsurg.143.11.1082 Torzilli G, Donadon M, Marconi M, et al. (2008) Hepatectomy for stage B and stage C hepatocellular carcinoma in the Barcelona Clinic Liver Cancer classification: results of a prospective analysis. Archiv Surg (Chicago, IL: 1960) 143(11):1082–1090. doi:10.​1001/​archsurg.​143.​11.​1082
6.
go back to reference Torzilli G, Belghiti J, Kokudo N, et al. (2013) A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: is it adherent to the EASL/AASLD recommendations? An observational study of the HCC East-West study group. Ann Surg 257(5):929–937. doi:10.1097/SLA.0b013e31828329b8 CrossRefPubMed Torzilli G, Belghiti J, Kokudo N, et al. (2013) A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: is it adherent to the EASL/AASLD recommendations? An observational study of the HCC East-West study group. Ann Surg 257(5):929–937. doi:10.​1097/​SLA.​0b013e31828329b8​ CrossRefPubMed
7.
go back to reference Hsu CY, Hsia CY, Huang YH, et al. (2012) Comparison of surgical resection and transarterial chemoembolization for hepatocellular carcinoma beyond the Milan criteria: a propensity score analysis. Ann Surg Oncol 19(3):842–849. doi:10.1245/s10434-011-2060-1 CrossRefPubMed Hsu CY, Hsia CY, Huang YH, et al. (2012) Comparison of surgical resection and transarterial chemoembolization for hepatocellular carcinoma beyond the Milan criteria: a propensity score analysis. Ann Surg Oncol 19(3):842–849. doi:10.​1245/​s10434-011-2060-1 CrossRefPubMed
8.
9.
go back to reference Poon RT, Fan ST, Lo CM, Liu CL, Wong J (2002) Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg 235(3):373–382CrossRefPubMedPubMedCentral Poon RT, Fan ST, Lo CM, Liu CL, Wong J (2002) Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg 235(3):373–382CrossRefPubMedPubMedCentral
12.
go back to reference Poon RT, Fan ST, Ng IO, et al. (2000) Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer 89(3):500–507CrossRefPubMed Poon RT, Fan ST, Ng IO, et al. (2000) Different risk factors and prognosis for early and late intrahepatic recurrence after resection of hepatocellular carcinoma. Cancer 89(3):500–507CrossRefPubMed
13.
go back to reference Shimada M, Takenaka K, Gion T, et al. (1996) Prognosis of recurrent hepatocellular carcinoma: a 10-year surgical experience in Japan. Gastroenterology 111(3):720–726CrossRefPubMed Shimada M, Takenaka K, Gion T, et al. (1996) Prognosis of recurrent hepatocellular carcinoma: a 10-year surgical experience in Japan. Gastroenterology 111(3):720–726CrossRefPubMed
16.
17.
go back to reference Li T, Wang SK, Zhou J, et al. (2016) Positive HBcAb is associated with higher risk of early recurrence and poorer survival after curative resection of HBV-related HCC. Liver Int 36(2):284–292. doi:10.1111/liv.12898 CrossRefPubMed Li T, Wang SK, Zhou J, et al. (2016) Positive HBcAb is associated with higher risk of early recurrence and poorer survival after curative resection of HBV-related HCC. Liver Int 36(2):284–292. doi:10.​1111/​liv.​12898 CrossRefPubMed
19.
go back to reference Young AL, Lodge JP (2009) Needle-track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut 58(6):887–888PubMed Young AL, Lodge JP (2009) Needle-track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut 58(6):887–888PubMed
20.
21.
23.
go back to reference Ganeshan B, Panayiotou E, Burnand K, Dizdarevic S, Miles K (2012) Tumour heterogeneity in non-small cell lung carcinoma assessed by CT texture analysis: a potential marker of survival. Eur Radiol 22(4):796–802. doi:10.1007/s00330-011-2319-8 CrossRefPubMed Ganeshan B, Panayiotou E, Burnand K, Dizdarevic S, Miles K (2012) Tumour heterogeneity in non-small cell lung carcinoma assessed by CT texture analysis: a potential marker of survival. Eur Radiol 22(4):796–802. doi:10.​1007/​s00330-011-2319-8 CrossRefPubMed
24.
go back to reference Ng F, Ganeshan B, Kozarski R, Miles KA, Goh V (2013) Assessment of primary colorectal cancer heterogeneity by using whole-tumor texture analysis: contrast-enhanced CT texture as a biomarker of 5-year survival. Radiology 266(1):177–184. doi:10.1148/radiol.12120254 CrossRefPubMed Ng F, Ganeshan B, Kozarski R, Miles KA, Goh V (2013) Assessment of primary colorectal cancer heterogeneity by using whole-tumor texture analysis: contrast-enhanced CT texture as a biomarker of 5-year survival. Radiology 266(1):177–184. doi:10.​1148/​radiol.​12120254 CrossRefPubMed
25.
go back to reference Ganeshan B, Skogen K, Pressney I, Coutroubis D, Miles K (2012) Tumour heterogeneity in oesophageal cancer assessed by CT texture analysis: preliminary evidence of an association with tumour metabolism, stage, and survival. Clin Radiol 67(2):157–164. doi:10.1016/j.crad.2011.08.012 CrossRefPubMed Ganeshan B, Skogen K, Pressney I, Coutroubis D, Miles K (2012) Tumour heterogeneity in oesophageal cancer assessed by CT texture analysis: preliminary evidence of an association with tumour metabolism, stage, and survival. Clin Radiol 67(2):157–164. doi:10.​1016/​j.​crad.​2011.​08.​012 CrossRefPubMed
27.
go back to reference Huang YQ, Liang CH, He L, et al. (2016) Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer. J Clin Oncol . doi:10.1200/jco.2015.65.9128 Huang YQ, Liang CH, He L, et al. (2016) Development and validation of a radiomics nomogram for preoperative prediction of lymph node metastasis in colorectal cancer. J Clin Oncol . doi:10.​1200/​jco.​2015.​65.​9128
28.
go back to reference Liang C, Huang Y, He L, et al. (2016) The development and validation of a CT-based radiomics signature for the preoperative discrimination of stage I–II and stage III–IV colorectal cancer. Oncotarget . doi:10.18632/oncotarget.8919 Liang C, Huang Y, He L, et al. (2016) The development and validation of a CT-based radiomics signature for the preoperative discrimination of stage I–II and stage III–IV colorectal cancer. Oncotarget . doi:10.​18632/​oncotarget.​8919
29.
go back to reference Chang PE, Ong WC, Lui HF, Tan CK (2008) Is the prognosis of young patients with hepatocellular carcinoma poorer than the prognosis of older patients? A comparative analysis of clinical characteristics, prognostic features, and survival outcome. J Gastroenterol 43(11):881–888. doi:10.1007/s00535-008-2238-x CrossRefPubMed Chang PE, Ong WC, Lui HF, Tan CK (2008) Is the prognosis of young patients with hepatocellular carcinoma poorer than the prognosis of older patients? A comparative analysis of clinical characteristics, prognostic features, and survival outcome. J Gastroenterol 43(11):881–888. doi:10.​1007/​s00535-008-2238-x CrossRefPubMed
31.
go back to reference Banerjee S, Wang DS, Kim HJ, et al. (2015) A computed tomography radiogenomic biomarker predicts microvascular invasion and clinical outcomes in hepatocellular carcinoma. Hepatology (Baltimore, MD) 62(3):792–800. doi:10.1002/hep.27877 CrossRef Banerjee S, Wang DS, Kim HJ, et al. (2015) A computed tomography radiogenomic biomarker predicts microvascular invasion and clinical outcomes in hepatocellular carcinoma. Hepatology (Baltimore, MD) 62(3):792–800. doi:10.​1002/​hep.​27877 CrossRef
34.
go back to reference Jr HF (2015) Regression modeling strategies with applications to linear models, logistic and ordinal regression, and survival analysis. New York, NY: Springer-Verlag Jr HF (2015) Regression modeling strategies with applications to linear models, logistic and ordinal regression, and survival analysis. New York, NY: Springer-Verlag
35.
go back to reference Sauerbrei W, Royston P, Binder H (2007) Selection of important variables and determination of functional form for continuous predictors in multivariable model building. Stat Med 26(30):5512–5528. doi:10.1002/sim.3148 CrossRefPubMed Sauerbrei W, Royston P, Binder H (2007) Selection of important variables and determination of functional form for continuous predictors in multivariable model building. Stat Med 26(30):5512–5528. doi:10.​1002/​sim.​3148 CrossRefPubMed
36.
go back to reference Zimmerman MA, Ghobrial RM, Tong MJ, et al. (2008) Recurrence of hepatocellular carcinoma following liver transplantation: a review of preoperative and postoperative prognostic indicators. Archiv Surg (Chicago, IL: 1960) 143(2):182–188 (discussion 188). doi:10.1001/archsurg.2007.39 Zimmerman MA, Ghobrial RM, Tong MJ, et al. (2008) Recurrence of hepatocellular carcinoma following liver transplantation: a review of preoperative and postoperative prognostic indicators. Archiv Surg (Chicago, IL: 1960) 143(2):182–188 (discussion 188). doi:10.​1001/​archsurg.​2007.​39
37.
go back to reference Richards CH, Mohammed Z, Qayyum T, Horgan PG, McMillan DC (2011) The prognostic value of histological tumor necrosis in solid organ malignant disease: a systematic review. Future Oncol (London, England) 7(10):1223–1235. doi:10.2217/fon.11.99 CrossRef Richards CH, Mohammed Z, Qayyum T, Horgan PG, McMillan DC (2011) The prognostic value of histological tumor necrosis in solid organ malignant disease: a systematic review. Future Oncol (London, England) 7(10):1223–1235. doi:10.​2217/​fon.​11.​99 CrossRef
38.
go back to reference Wang Y, Liao J, Qi W, Xie L, Li Y (2016) Predictive value of conventional ultrasound and contrast-enhanced ultrasound in early recurrence of hepatocellular carcinoma after surgical resection. Ultrasound Med Biol . doi:10.1016/j.ultrasmedbio.2015.12.010 Wang Y, Liao J, Qi W, Xie L, Li Y (2016) Predictive value of conventional ultrasound and contrast-enhanced ultrasound in early recurrence of hepatocellular carcinoma after surgical resection. Ultrasound Med Biol . doi:10.​1016/​j.​ultrasmedbio.​2015.​12.​010
40.
go back to reference Qi X, Liu L, Wang D, et al. (2015) Hepatic resection alone versus in combination with pre- and post-operative transarterial chemoembolization for the treatment of hepatocellular carcinoma: a systematic review and meta-analysis. Oncotarget 6(34):36838–36859. doi:10.18632/oncotarget.5426 PubMedPubMedCentral Qi X, Liu L, Wang D, et al. (2015) Hepatic resection alone versus in combination with pre- and post-operative transarterial chemoembolization for the treatment of hepatocellular carcinoma: a systematic review and meta-analysis. Oncotarget 6(34):36838–36859. doi:10.​18632/​oncotarget.​5426 PubMedPubMedCentral
41.
go back to reference Mathurin P, Raynard B, Dharancy S, et al. (2003) Meta-analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma. Aliment Pharmacol Ther 17(10):1247–1261CrossRefPubMed Mathurin P, Raynard B, Dharancy S, et al. (2003) Meta-analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma. Aliment Pharmacol Ther 17(10):1247–1261CrossRefPubMed
42.
Metadata
Title
CT-based radiomics signature: a potential biomarker for preoperative prediction of early recurrence in hepatocellular carcinoma
Authors
Ying Zhou
Lan He
Yanqi Huang
Shuting Chen
Penqi Wu
Weitao Ye
Zaiyi Liu
Changhong Liang
Publication date
01-06-2017
Publisher
Springer US
Published in
Abdominal Radiology / Issue 6/2017
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-017-1072-0

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