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European Radiology
Published in: European Radiology 12/2022

09-06-2022 | Computed Tomography | Computed Tomography

Nomogram based on CT–derived extracellular volume for the prediction of post-hepatectomy liver failure in patients with resectable hepatocellular carcinoma

Authors: Yangling Peng, Hesong Shen, Hao Tang, Yuanying Huang, Xiaosong Lan, Xianzhang Luo, Xiaoyue Zhang, Jiuquan Zhang

Published in: European Radiology | Issue 12/2022

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Abstract

Objectives

This study aimed to develop and validate a nomogram based on extracellular volume (ECV) derived from computed tomography (CT) for predicting post-hepatectomy liver failure (PHLF) in patients with resectable hepatocellular carcinoma (HCC).

Methods

A total of 202 patients with resectable HCC from two hospitals were enrolled and underwent multiphasic contrast-enhanced CT before surgery. One hundred twenty-one patients from our hospital and 81 patients from another hospital were assigned to the training cohort and the validation cohort, respectively. CT–derived ECV was measured using nonenhanced and equilibrium-phase-enhanced CT images. The nomogram was developed with independent predictors of PHLF. Predictive performance and calibration were assessed by receiver operator characteristic (ROC) analysis and Hosmer–Lemeshow test, respectively. The Delong test was used to compare the areas under the curve (AUCs).

Results

CT–derived ECV had a strong correlation with the postoperative pathological fibrosis stage of the background liver (p < 0.001, r = 0.591). The nomogram combining CT–derived ECV, serum albumin (Alb), and serum total bilirubin (Tbil) obtained higher AUCs than the albumin–bilirubin (ALBI) score for predicting PHLF in both the training cohort (0.828 vs. 0.708; p = 0.004) and the validation cohort (0.821 vs. 0.630; p < 0.001). The nomogram showed satisfactory goodness of fit for PHLF prediction in the training and validation cohorts (p = 0.621 and 0.697, respectively).

Conclusions

The nomogram contributes to the preoperative prediction of PHLF in patients with resectable HCC.

Key Points

• CT–derived ECV had a strong correlation with the postoperative pathological fibrosis stage of the background liver.
• CT–derived ECV was an independent predictor of PHLF in patients with resectable HCC.
• The nomogram based on CT–derived ECV showed a superior prediction efficacy than that of clinical models (including Child–Pugh stage, MELD score, and ALBI score).
Appendix
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Metadata
Title
Nomogram based on CT–derived extracellular volume for the prediction of post-hepatectomy liver failure in patients with resectable hepatocellular carcinoma
Authors
Yangling Peng
Hesong Shen
Hao Tang
Yuanying Huang
Xiaosong Lan
Xianzhang Luo
Xiaoyue Zhang
Jiuquan Zhang
Publication date
09-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08917-x

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