Predicting histopathological growth patterns and prognosis of colorectal liver metastases using MRI
摘要
To identify MR imaging features of replacement histopathological growth patterns (rHGPs) of colorectal liver metastases (CRLMs) distinguishable from those of desmoplastic HGPs (dHGPs) and explore their relationships with prognosis.
Materials and methodsSeventy-nine patients with 104 CRLMs who underwent gadoxetic acid-enhanced MR followed by partial hepatectomy were included as a derivation cohort. The CRLMs were rHGPs or dHGPs. MR images of the CRLMs, focusing on the tumor and segmented tumor–liver interface zones (peritumoral area), were quantitatively evaluated and statistically analyzed. The statistically significant findings from the derivation cohort were validated in an independent external cohort.
ResultsIn the derivation cohort, there were no significant differences among tumor sizes, contrast-to-noise ratios (CNRs), or enhancement ratios (ERs) of the tumors with rHGPs (n = 43) and dHGPs (n = 61) (p > 0.05). The peritumoral area was only identified during the arterial and portal phases. The thickness, CNR, and ER of the peritumoral area on the arterial and portal phase images of the rHGP group were significantly larger than those of the dHGP group (p < 0.05). The area under the ROC curve for predicting rHGP based on CNR during the arterial phase was the highest at 0.920. The peritumoral area CNR during the arterial phase was associated with a poor prognosis (p < 0.05). The usefulness of these parameters was confirmed in the validation cohort (p < 0.05).
ConclusionThe CRLMs with rHGPs had thicker peritumoral areas with higher CNR and ER during the arterial phase, and the CNR during the arterial phase was an independent indicator of poor prognosis.
Key Points