Assessment of factors affecting washout appearance of hepatocellular carcinoma on CT
Objectives To identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images. Methods This retrospective study included 264 patients who had undergone surgical resection for treatment-naïve single HCC between January 2014 and De...
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Published in | European radiology Vol. 31; no. 10; pp. 7760 - 7770 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.10.2021
Springer Nature B.V |
Subjects | |
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Abstract | Objectives
To identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images.
Methods
This retrospective study included 264 patients who had undergone surgical resection for treatment-naïve single HCC between January 2014 and December 2015 and had available preoperative multiphasic CT images. Two reviewers evaluated the CT imaging features of HCC using LI-RADS v2018. The “washout” was visually assessed in portal venous or equilibrium phases. Depending on the presence of washout appearance of HCC, all patients were divided into “washout” (
n =
228) and “no washout” (
n =
36) groups. Multivariable logistic regression analysis was used to identify factors associated with the absence of washout appearance of HCC.
Results
A total of 264 HCCs (median size, 2.6 cm) were analyzed. Histologically proven hepatic steatosis (macrovesicular steatosis ≥ 5%) (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.05–6.74;
p =
0.040), tumor capsule on histopathology (OR, 0.17; 95% CI, 0.06–0.50;
p =
0.001), and mosaic appearance on CT image (OR, 0.34; 95% CI, 0.14–0.85;
p =
0.021) were independent factors associated with the absence of washout appearance of HCC. In 189 patients with available unenhanced CT images, CT-diagnosed hepatic steatosis was also an independent factor for the absence of washout appearance of HCC (OR, 9.26; 95% CI, 3.06–28.02;
p
< 0.001).
Conclusions
Washout appearance of HCC in CT images could be obscured in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis, and could be enhanced with tumor capsule on histopathology and mosaic appearance on CT image.
Key Points
•
Hepatic steatosis is an independent factor related to the absence of washout appearance of hepatocellular carcinoma in CT images, in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis
.
•
Both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis have higher odds of absence of washout appearance of hepatocellular carcinoma compared to non-steatotic liver
.
•
Tumor capsule on histopathology and mosaic appearance on CT image are independent factors that enhance the probability that washout appearance of hepatocellular carcinoma is visible
. |
---|---|
AbstractList | Objectives
To identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images.
Methods
This retrospective study included 264 patients who had undergone surgical resection for treatment-naïve single HCC between January 2014 and December 2015 and had available preoperative multiphasic CT images. Two reviewers evaluated the CT imaging features of HCC using LI-RADS v2018. The “washout” was visually assessed in portal venous or equilibrium phases. Depending on the presence of washout appearance of HCC, all patients were divided into “washout” (
n =
228) and “no washout” (
n =
36) groups. Multivariable logistic regression analysis was used to identify factors associated with the absence of washout appearance of HCC.
Results
A total of 264 HCCs (median size, 2.6 cm) were analyzed. Histologically proven hepatic steatosis (macrovesicular steatosis ≥ 5%) (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.05–6.74;
p =
0.040), tumor capsule on histopathology (OR, 0.17; 95% CI, 0.06–0.50;
p =
0.001), and mosaic appearance on CT image (OR, 0.34; 95% CI, 0.14–0.85;
p =
0.021) were independent factors associated with the absence of washout appearance of HCC. In 189 patients with available unenhanced CT images, CT-diagnosed hepatic steatosis was also an independent factor for the absence of washout appearance of HCC (OR, 9.26; 95% CI, 3.06–28.02;
p
< 0.001).
Conclusions
Washout appearance of HCC in CT images could be obscured in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis, and could be enhanced with tumor capsule on histopathology and mosaic appearance on CT image.
Key Points
•
Hepatic steatosis is an independent factor related to the absence of washout appearance of hepatocellular carcinoma in CT images, in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis
.
•
Both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis have higher odds of absence of washout appearance of hepatocellular carcinoma compared to non-steatotic liver
.
•
Tumor capsule on histopathology and mosaic appearance on CT image are independent factors that enhance the probability that washout appearance of hepatocellular carcinoma is visible
. OBJECTIVESTo identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images. METHODSThis retrospective study included 264 patients who had undergone surgical resection for treatment-naïve single HCC between January 2014 and December 2015 and had available preoperative multiphasic CT images. Two reviewers evaluated the CT imaging features of HCC using LI-RADS v2018. The "washout" was visually assessed in portal venous or equilibrium phases. Depending on the presence of washout appearance of HCC, all patients were divided into "washout" (n = 228) and "no washout" (n = 36) groups. Multivariable logistic regression analysis was used to identify factors associated with the absence of washout appearance of HCC. RESULTSA total of 264 HCCs (median size, 2.6 cm) were analyzed. Histologically proven hepatic steatosis (macrovesicular steatosis ≥ 5%) (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.05-6.74; p = 0.040), tumor capsule on histopathology (OR, 0.17; 95% CI, 0.06-0.50; p = 0.001), and mosaic appearance on CT image (OR, 0.34; 95% CI, 0.14-0.85; p = 0.021) were independent factors associated with the absence of washout appearance of HCC. In 189 patients with available unenhanced CT images, CT-diagnosed hepatic steatosis was also an independent factor for the absence of washout appearance of HCC (OR, 9.26; 95% CI, 3.06-28.02; p < 0.001). CONCLUSIONSWashout appearance of HCC in CT images could be obscured in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis, and could be enhanced with tumor capsule on histopathology and mosaic appearance on CT image. KEY POINTS• Hepatic steatosis is an independent factor related to the absence of washout appearance of hepatocellular carcinoma in CT images, in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis. • Both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis have higher odds of absence of washout appearance of hepatocellular carcinoma compared to non-steatotic liver. • Tumor capsule on histopathology and mosaic appearance on CT image are independent factors that enhance the probability that washout appearance of hepatocellular carcinoma is visible. To identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images. This retrospective study included 264 patients who had undergone surgical resection for treatment-naïve single HCC between January 2014 and December 2015 and had available preoperative multiphasic CT images. Two reviewers evaluated the CT imaging features of HCC using LI-RADS v2018. The "washout" was visually assessed in portal venous or equilibrium phases. Depending on the presence of washout appearance of HCC, all patients were divided into "washout" (n = 228) and "no washout" (n = 36) groups. Multivariable logistic regression analysis was used to identify factors associated with the absence of washout appearance of HCC. A total of 264 HCCs (median size, 2.6 cm) were analyzed. Histologically proven hepatic steatosis (macrovesicular steatosis ≥ 5%) (odds ratio [OR], 2.65; 95% confidence interval [CI], 1.05-6.74; p = 0.040), tumor capsule on histopathology (OR, 0.17; 95% CI, 0.06-0.50; p = 0.001), and mosaic appearance on CT image (OR, 0.34; 95% CI, 0.14-0.85; p = 0.021) were independent factors associated with the absence of washout appearance of HCC. In 189 patients with available unenhanced CT images, CT-diagnosed hepatic steatosis was also an independent factor for the absence of washout appearance of HCC (OR, 9.26; 95% CI, 3.06-28.02; p < 0.001). Washout appearance of HCC in CT images could be obscured in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis, and could be enhanced with tumor capsule on histopathology and mosaic appearance on CT image. • Hepatic steatosis is an independent factor related to the absence of washout appearance of hepatocellular carcinoma in CT images, in both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis. • Both histologically proven hepatic steatosis and CT-diagnosed hepatic steatosis have higher odds of absence of washout appearance of hepatocellular carcinoma compared to non-steatotic liver. • Tumor capsule on histopathology and mosaic appearance on CT image are independent factors that enhance the probability that washout appearance of hepatocellular carcinoma is visible. |
Author | Min, Ji Hye Kim, Young Kon Kang, Tae Wook Jeong, Woo Kyoung Hwang, Jeong Ah Ko, Seong Eun Choi, Seo-Youn |
Author_xml | – sequence: 1 givenname: Jeong Ah surname: Hwang fullname: Hwang, Jeong Ah organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 2 givenname: Ji Hye orcidid: 0000-0002-8496-6771 surname: Min fullname: Min, Ji Hye email: minjh1123@gmail.com organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 3 givenname: Tae Wook surname: Kang fullname: Kang, Tae Wook organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 4 givenname: Woo Kyoung surname: Jeong fullname: Jeong, Woo Kyoung organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 5 givenname: Young Kon surname: Kim fullname: Kim, Young Kon organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 6 givenname: Seong Eun surname: Ko fullname: Ko, Seong Eun organization: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine – sequence: 7 givenname: Seo-Youn surname: Choi fullname: Choi, Seo-Youn organization: Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33856517$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_3389_fonc_2023_1214977 crossref_primary_10_1007_s00330_024_10846_w crossref_primary_10_1007_s11604_022_01295_w crossref_primary_10_1016_j_semcancer_2023_04_010 |
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Keywords | Fatty liver Carcinoma, Hepatocellular Diagnosis Tomography, X-ray computed |
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Snippet | Objectives
To identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images.
Methods... To identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images. This retrospective... ObjectivesTo identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images.MethodsThis... OBJECTIVESTo identify independent imaging and histopathologic factors that affect washout appearance of hepatocellular carcinoma (HCC) in CT images.... |
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SubjectTerms | Computed tomography Confidence intervals Diagnostic Radiology Fatty liver Hepatobiliary-Pancreas Hepatocellular carcinoma Histopathology Image enhancement Imaging Internal Medicine Interventional Radiology Liver cancer Medical diagnosis Medical imaging Medicine Medicine & Public Health Neuroradiology Patients Radiology Regression analysis Statistical analysis Steatosis Tomography Tumors Ultrasound |
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Title | Assessment of factors affecting washout appearance of hepatocellular carcinoma on CT |
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