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European Radiology
Published in: European Radiology 5/2020

01-05-2020 | Magnetic Resonance Imaging | Imaging Informatics and Artificial Intelligence

A radiomics-based biomarker for cytokeratin 19 status of hepatocellular carcinoma with gadoxetic acid–enhanced MRI

Authors: Wentao Wang, Dongsheng Gu, Jingwei Wei, Ying Ding, Li Yang, Kai Zhu, Rongkui Luo, Sheng-Xiang Rao, Jie Tian, Mengsu Zeng

Published in: European Radiology | Issue 5/2020

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Abstract

Objectives

We aimed to develop a radiomics-based model derived from gadoxetic acid–enhanced MR images to preoperatively identify cytokeratin (CK) 19 status of hepatocellular carcinoma (HCC).

Methods

A cohort of 227 patients with single HCC was classified into a training set (n = 159) and a time-independent validated set (n = 68). A total of 647 radiomic features were extracted from multi-sequence MR images. The least absolute shrinkage and selection operator regression and decision tree methods were utilized for feature selection and radiomics signature construction. A multivariable logistic regression model incorporating clinico-radiological features and the fusion radiomics signature was built for prediction of CK19 status by evaluating area under curve (AUC).

Results

In the whole cohort, 57 patients were CK19 positive and 170 patients were CK19 negative. By combining 11 and 6 radiomic features extracted in arterial phase and hepatobiliary phase images, respectively, a fusion radiomics signature achieved AUCs of 0.951 and 0.822 in training and validation datasets. The final combined model integrated a-fetoprotein levels, arterial rim enhancement pattern, irregular tumor margin, and the fusion radiomics signature, with a sensitivity of 0.818 and specificity of 0.974 in the training cohort and that of 0.769 and 0.818 in the validated cohort. The nomogram based on the combined model showed satisfactory prediction performance in training (C-index 0.959) and validation (C-index 0.846) dataset.

Conclusions

The combined model based on a fusion radiomics signature derived from arterial and hepatobiliary phase images of gadoxetic acid–enhanced MRI can be a reliable biomarker for CK19 status of HCC.

Key Points

• Arterial rim enhancement pattern and irregular tumor margin on hepatobiliary phase on gadoxetic acid–enhanced MRI can be useful for evaluating CK19 status of HCC.
• A radiomics-based model performed better than the clinico-radiological model both in training and validation datasets for predicting CK19 status of HCC.
• The nomogram based on the fusion radiomics signature can be easily used for CK19 stratification of HCC.
Appendix
Available only for authorised users
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Metadata
Title
A radiomics-based biomarker for cytokeratin 19 status of hepatocellular carcinoma with gadoxetic acid–enhanced MRI
Authors
Wentao Wang
Dongsheng Gu
Jingwei Wei
Ying Ding
Li Yang
Kai Zhu
Rongkui Luo
Sheng-Xiang Rao
Jie Tian
Mengsu Zeng
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06585-y

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