Preoperative MRI For Predicting Early Recurrence Of Solitary Hepatocellular Carcinoma Without Microvascular Invasion

Objectives: This study aimed to identify preoperative MR imaging features for predicting early recurrence after curative resection of solitary hepatocellular carcinoma(HCC)without microvascular invasion(MVI).Methods: The data of 124 patients with MVI-negative solitary hepatocellular carcinoma confirmed by operation and pathology were analyzed retrospectively.Ten liver imaging reports and data system(LI-RADS v2018)features and three non-LI-RADS features were observed on images.Univariable and multivariable Cox regression were used to analyze the correlation between preoperative MR imaging features,clinical data and early recurrence(ER)within 2 years after operation.And then a nomogram was constructed for individualized risk estimation,and its accuracy and discriminative ability were evaluated by concordance index(C-index)and calibration curve.Results:Univariable analysis showed that there were significant differences in NRL(p=0.015),tumor size(p=0.040),nonsmooth tumor margin(p=0.008),tumor capsule(p=0.003)and presence of mosaic architecture(p=0.007)between the ER group and the non-ER group.In multivariable analysis,tumor size(p=0.045),nonsmooth tumor margin(p=0.013),and presence of mosaic architecture(p=0.035)were independent significant variables associated with ER.The nomogram based on these three variables had a good prediction efficiency.The C-index of the nomogram was 0.743(95% CI: 0.697-0.788).And the correction curve showed a good coincidence with the actual disease-free survival time.Conclusion: Preoperative MRI imaging features play an important role in predicting early recurrence of MVI-negative solitary hepatocellular carcinoma.The nomgram based on MRI features provides a visual risk assessment tool for predicting early recurrence in solitary hepatocellular carcinoma without microvascular invasion,which is helpful to provide a reference basis for individualized treatment.