Objective To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI nomogram in preoperative prediction of the Ki-67 expression status in hepatocellular carcinoma(HCC).Methods A retrospective analysis was conducted on 122 HCC patients diagnosed pathologically from January 2022 to May 2024 at our hospital.Patients were divided into high Ki-67 expression(n=71)and low Ki-67 expression(n=51)groups based on postoperative immunohistochemical cell proliferation levels(Ki-67 index).The patients were then randomly allocated to a training set(n=85)and a validation set(n=37)in proportion.Differences in imaging parameters[tumor diameter,margin,pseudocapsule,apparent diffusion coefficient(ADC)of the tumor area,signal intensity ratio(SIR)of the hepatobiliary phase to normal liver parenchyma,and peritumoral hypointensity],alpha fetoprotein concentration,and tumor differentiation degree between the two groups were analyzed.The most valuable parameters were selected using LASSO regression,and a predictive model was established through multivariate logistic regression analysis.The performance of the model was evaluated using ROC curves,calibration curves,and decision curves.Results In both the training and validation sets,the high Ki-67 expression group had higher alpha fetoprotein levels(≥20 ng/mL),more irregular tumor margins,and more frequent peritumoral hypointensity compared to the low Ki-67 expression group.The ADC values and SIR were lower in the high Ki-67 expression group,with statistically significant differences(P＜0.05).However,there were no significant differences in tumor diameter and presence of pseudocapsules(P＞0.05).LASSO regression identified three most valuable parameters(tumor ADC,SIR,and tumor differentiation degree).Multivariate logistic regression analysis showed that ADC and SIR were influencing factors for Ki-67 expression.Based on these parameters,a Nomogram model was established.The calibration curve of the model fit well with the ideal curve,and the area under the ROC curve was 0.827,with a sensitivity of 81.2%and specificity of 80%.Conclusion Gd-EOB-DTPA enhanced MRI nomogram can effectively predict the Ki-67 expression status in HCC preoperatively,facilitating risk stratification and personalized treatment for HCC patients.
万方数据
维普
