Predictive value of preoperative MRI for recurrence in patients with hepatocellular carci-noma after radiofrequency ablation
Objective To investigate the predictive value of preoperative magnetic resonance imaging(MRI)for the postop-erative recurrence of hepatocellular carcinoma(HCC)after radiofrequency ablation.Methods A total of 80 patients with HCC who underwent radiofrequency ablation in Beijing Municipal Corps Hospital of Chinese People's Armed Police Force and the Fifth Medical Center of PLA General Hospital from July 2013 to July 2019 were selected.All patients underwent contrast-enhanced MRI examination within one week before surgery,and were followed up for recurrence within three years.According to whether they had recurrence,the patients were divided into recurrence group and non-recurrence group.The general data and MR features of the two groups were com-pared,and COX regression was used to analyze the factors affecting postoperative recurrence of HCC.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of each parameter value in predicting the recurrence of HCC after radiofrequency abla-tion.Results During a 3-year follow-up,there were 19 cases(23.75%)of recurrence and 61 cases(76.25%)of no recurrence.There was no statistically significant difference in gender,age,tumor location,or alpha fetoprotein(AFP)between the two groups.Univariate analysis showed statistical differences in tumor margin(P=0.019),intratumoral fat(P=0.013),peritumoral enhancement(P=0.049),tumor capsule(P=0.003),and the spacing between tumor and large vessel(P=0.035).COX multivariate analysis showed that tumor margin(HR=3.049,95%CI:1.131-8.218),intratumoral fat(HR=0.264,95%CI:0.095-0.740),and tumor capsule(HR=0.305,95%CI:0.107-0.866)were the independent factors for postoperative recurrence in HCC patients.The area under ROC curve for the combined diagnosis of tumor margin,tumor capsule and intratumoral fat for postoperative recurrence of HCC was 0.838,with sensitivity and specificity of 84.21%and 73.77%,respectively,which had a higher predictive value than using tumor margin,tumor capsule,or intratumoral fat alone.Conclusions MR features have certain predictive value in predicting the recurrence of HCC after radiofrequency ablation,which can pro-vide reference for clinical treatment.
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