13:30 | 0913.
| Predictive Model for Proliferative HCC Using LI-RADS v2018: Assessing Therapeutic Outcomes in Hepatectomy and Systemic Therapy Mengtian Lu1, Xueqin Zhang1, Tao Zhang1, Qi Qu1, Zuyi Yan1, and Xiance Zhao2 1Nantong Third People's Hospital, Nantong, China, 2Philips Healthcare, Nantong, China Keywords: Liver, Data Analysis Motivation: Hepatocellular carcinoma (HCC) can be categorized into proliferative and non-proliferative classes, with proliferative HCC exhibiting aggressive characteristics and a poor prognosis. Goal(s): To develop a predictive model for proliferative HCC using Liver Imaging Reporting and Data System (LI-RADS) and to investigate its prognostic value for HCC. Approach: A logistic regression nomogram was constructed based on LI-RADS features to identify proliferative HCC. The implication of model-predicted proliferative HCC for different therapeutic outcomes in HCC was investigated. Results: The predictive model for proliferative HCC performed well and is a risk factor for postoperative recurrence in HCC, associated with favorable outcomes in systemic therapy. Impact: The MR-based model, utilizing
LI-RADS v2018, could predict proliferative HCC before treatment. Patients with model-predicted
proliferative HCC had more post-hepatectomy recurrences but better responses to
systemic therapy, which may facilitate clinical decision-making for more
precise and rational therapeutic strategies. |
13:42 | 0914.
| Improved Hepatocellular Carcinoma Targeted Combination Immunotherapy Using a Nanocarrier: Monitoring Tumor Response via Functional MRI Jiamin Li1, Ruili Wei1, Ruimeng Yang1, Xinqing Jiang1, and Yongzhou Xu2 1Department of Radiology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China, 2Philips Healthcare, Guangzhou, China Keywords: Liver, fMRI, Hepatocellular Carcinoma; Immunotherapy; Nanocarrier; IVIM-MRI; Tumor Microenvironment Motivation: To enhance the efficacy of hepatocellular carcinoma immunotherapy using a nanocarrier and to explore IVIM-MRI for monitoring the tumor immune microenvironment. Goal(s): To synthesize iRGD-targeted liposomes to enhance the treatment efficacy of hepatocellular carcinoma and to develop effective biomarkers for the tumor microenvironment. Approach: We synthesized iRGD-modified liposomal co-encapsulating Lenvatinib and BMS-202. IVIM-MRI was performed before and at 6 and 12 days after treatments, followed by pathological examination after the final scan. Results: iRGD-lip@Len/BMS-202 promotes tumor vascular normalization and effectively activates an anti-tumor immune response. Importantly, the derived parameters D* and f are significantly correlated with tumor vascular normalization and immune activation. Impact: The iRGD-targeted dual-drug liposomal nanoparticles exhibited potent synergistic anti-tumor effects. Additionally, IVIM-MRI facilitated the monitoring of changes in the tumor microenvironment, with the D* and f parameters serving as valuable indicators for evaluating tumor vascular network and immune microenvironment modulation. |
13:54 | 0915.
| Enhancing Hepatocellular Carcinoma (HCC) Diagnosis Through TWIST MRI Sequence Mohamed Elboraey1 and Jordon D. LeGout1 1Radiology, Mayo Clinic, Jacksonville, FL, United States Keywords: Liver, Tumor, Hepatocellular carcinoma Motivation: Our report targets precise timing in hepatocellular carcinoma (HCC) diagnosis via MRI. Timely recognition of the late hepatic arterial phase is crucial to avoid unnecessary invasive biopsies and minimize patient risks. Goal(s): Our report evaluates the TWIST technique's effectiveness in HCC diagnosis, aiming to reduce the need for percutaneous biopsies. Approach: We integrated TWIST into our liver MRI protocols, capturing images at preset intervals, enhancing temporal resolution for HCC diagnosis. Results: Our report successfully employs the TWIST technique to diagnose HCC by capturing arterial hyperenhancement. This innovation improves diagnostic accuracy and diminishes the necessity for invasive procedures, benefiting patients. Impact: The implementation of the TWIST technique promises safer and
more accurate hepatocellular carcinoma (HCC) diagnosis. This technique minimizes
invasive biopsies, reshaping clinical practice and offering a new perspective
on non-invasive diagnostic techniques. |
14:06 | 0916.
| Intravoxel incoherent motion model for prediction of tertiary lymphoid structures in HCC. Lidi Ma1, Xiaolan Zhang2, Fan Zhou1, Zhijun Geng1, and Chuanmiao Xie1 1Department of radiology, Sun Yat-sen University Cancer Center, Guangzhou, China, 2Shukun Technology Co., Ltd, Beijing, China Keywords: Liver, Radiomics, Magnetic resonance imaging, IVIM, Hepatocellular carcinoma, tertiary lymphoid structures Motivation: Intra-tumoral tertiary lymphoid structures (TLSs) are associated with a favorable prognosis for patients with hepatocellular carcinoma (HCC). Intravoxel incoherent motion (IVIM) sequences describe heterogeneity of tumor components. Goal(s): We aimed to explore the value of intravoxel incoherent motion (IVIM) sequences in predicting TLSs. Approach: IVIM quantitative parameters and radiomics features were obtained. A fusion model based on the above and clinical characteristics was constructed. Receiver operating characteristic curve analysis was performed to assess the diagnostic performance of different models for TLSs prediction. Results: Radiomics features based on IVIM-DWI can be better conducive to preoperative prediction of TLSs in patients than IVIM parameter maps. Impact: TLSs exhibit considerable promise in prognostic
prediction and the identification of appropriate candidates for immunotherapy. The fusion model based on the IVIM-DWI showed great performance in predicting TLSs, assisting the selection of clinical immunotherapy patients. |
14:18 | 0917.
| Intertumoral Heterogeneity based on MRI Radiomics Features Predicts prognosis in HCC patients before Hepatectomy Mengshi Dong1, Yuanqiang Xiao1, Chao Li1, Lina Zhang1, Tianhui Zhang2, Jinhui Zhou1, Linqi Zhang3, Xin Jin1, Zebin Fang1, Mengsi Li1, Yu Han1, and Jin Wang1 1radiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, 2radiology, Meizhou People's Hospital, Meizhou, China, 3radiology, Third affliated hospital of San Yet-Sun university, Guangzhou, China Keywords: Liver, Liver, hepatocellular carcinoma Motivation: Hepatocellular carcinoma (HCC) exhibits significant intertumoral heterogeneity, which contributes significantly to treatment resistance and failure. Noninvasive imaging and radiomics for preoperative decoding of the subtypes and prognosis may be valuable in clinical management. Goal(s): To preoperatively develop and validate clustering analysis of HCC based on MRI radiomics features for identifying subtypes with discrete prognosis. Approach: We performed clustering analysis of HCC based on MRI radiomics features to detect distinct subtypes, and subsequently clinicopathological parameters and prognosis were compared and evaluated between different subtypes. Results: Based on the radiomics features of MRI, clustering analysis identified two distinct subtypes with discrete prognosis in HCC patients. Impact: Clustering
analysis based on the radiomics features of multiparametric MRI is a potential noninvasive
decision-making method for the management of patients with HCC in clinical
practice. |
14:30 | 0918.
| MR radiomics to predict microvascular invasion status and biological processes in combined hepatocellular carcinoma-cholangiocarcinoma Yuyao Xiao1 1radiology, Zhongshan Hospital Fudan University, Shanghai, China Keywords: Liver, Liver Motivation: Prognostic value of microvascular invasion (MVI) in combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) was verified, and an effective prediction model is warranted to facilitate risk stratification and individual management. Goal(s): To establish an MRI-based radiomics model for predicting MVI status of cHCC-CCA, and to investigate biological processes underlying the radiomics model. Approach: Clinical data, conventional MR features, MR-based radiomics features and RNA sequencing data were collected and analyzed. Results: A robust MRI-based radiomics model was established for predicting MVI status in cHCC-CCA, in which potential prognostic value and underlying biological processes that regulate immune response were demonstrated. Impact: MVI is a significant
manifestation of tumor invasiveness,and the MR-based radiomics model
established in our study will facilitate risk stratification. Furthermore, underlying
biological processes demonstrated in radiomics model will offer valuable
insights for guiding immunotherapy strategies. |
14:42 | 0919.
| MRI-based prediction of microvascular invasion or high tumor grade and adjuvant therapy benefit for solitary HCC ≤5 cm Hanyu Jiang1, Binrong Li2, Tianying Zheng3, Yun Qin3, Zhenru Wu3, Maxime Ronot4, Victoria Chernyak5, Kathryn J. Fowler6, Mustafa R. Bashir7, Weixia Chen3, Yuan-Cheng Wang2, Shenhong Ju2, and Bin Song3,8 1Radiology, West China Hospital, Sichuan University, Chengdu, China, 2Zhongda Hospital, Southeast University, Nanjing, China, 3West China Hospital, Sichuan University, Chengdu, China, 4Hôpital Beaujon, Clichy, France, 5Memorial Sloan Kettering Cancer Center, New York, NY, United States, 6University of California San Diego, San Diego, CA, United States, 7Duke University Medical Center, Durham, NC, United States, 8Sanya People’s Hospital, Sanya, China Keywords: Liver, Liver Motivation: Noninvasive assessment of high-risk histopathology (microvascular invasion or Edmondson-Steiner G3/4) for early HCC is critical but challenging. Goal(s): To develop an MRI-based diagnostic model for high-risk histopathology. Approach: This dual-center retrospective study included consecutive patients who underwent contrast-enhanced MRI and subsequent curative resection or RFA for solitary BCLC 0/A HCC≤5 cm. A diagnostic model was developed against pathology based on resection-treated patients. Results: 554 patients were included. Serum α-fetoprotein, non-simple nodular growth subtype, and the VICT2 trait constituted the model (testing center AUC, 0.828). Adjuvant therapies were associated with improved RFS (resection, P=.009; RFA, P=.009) for the model-positive patients. Impact: This dual-center study developed and externally validated a
diagnostic model which could effectively predict high-risk histopathology and
adjuvant therapy benefit for patients receiving curative resection or radiofrequency
ablation for solitary BCLC 0 or A HCCs ≤5 cm. |
14:54 | 0920.
| Simultaneous Multi-Slice Imaging in DKI and IVIM for Hepatocellular Carcinoma: Correlation with Microvascular Invasion and Histologic Grade Yingyi Wu1, Zheng Ye1, and Bin Song1,2 1West China Hospital, Sichuan University, Chengdu, China, 2Radiology Department, Sanya People’s Hospital, Sanya, China Keywords: Liver, Quantitative Imaging, Hepatocellular carcinoma (HCC); apparent diffusion coefficient (ADC); diffusion kurtosis imaging (DKI); Intravoxel incoherent motion diffusion-weighted imaging (IVIM); histologic grade; microvascular invasion (MVI) Motivation: IVIM and DKI, effective in HCC malignancy prediction, face limitations due to lengthy scan times. The Simultaneous Multi-Slice (SMS) technology has successfully reduced scan times for ADC studies, but its application in IVIM and DKI remains underexplored. Goal(s): To evaluate SMS-accelerated IVIM and DKI's efficacy in predicting HCC microvascular invasion (MVI) and tumor grading compared to conventional methods. Approach: The study enrolled 42 HCC patients, conducting MRI with both conventional and SMS-accelerated DWI, DKI, and IVIM. Results: SMS significantly reduced MRI scan times while maintaining reliable diffusion metrics, proving more effective than ADC in predicting MVI and tumor grades in HCC. Impact: Integrating SMS into IVIM and DKI
protocols can notably shorten scan times while preserving diagnostic accuracy
in MVI and tumor grading, potentially improving clinical efficiency and patient
management. |
15:06 | 0921.
| Quantitative parameters obtained from gadobenate dimeglumine-enhanced MRI can predict proliferative subtype of hepatocellular carcinoma. Feier Ding1, Chao Zhang1, Xu Qi1, Lianbang Wang1, Changhu Liang1, and Xinya Zhao1 1Shandong Provincial Hospital, Jinan, China Keywords: Liver, Cancer Motivation: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third leading cause of cancer-related death. Goal(s): This study investigated the value of gadobenate dimeglumine-enhanced quantitative parameters for predicting the proliferative subtype of HCC and patients’ prognosis. Approach: All HCC lesions were resected and pathologically confirmed. The lesion-to-liver contrast enhancement ratio (LLCER) was measured in the hepatobiliary phase. Results: LLCER was identified as an independent predictor of proliferative HCC. Patients with LLCER < -4.59% had a significantly higher incidence of proliferative HCC. In addition, patients with LLCER < -4.61% showed poorer overall survival than those with LLCER ≥ -4.61%. Impact: Quantitative information from gadobenate dimeglumine–enhanced MRI can provide crucial
information on hepatocellular carcinoma subtypes. It might be valuable to design novel therapeutic strategies, such as targeted therapies or immunotherapy. |
15:18 | | DiscussionScott Reeder University of Wisconsin, United States |