Microvascular Invasion Of Hepatocellular Carcinoma Predicted By Spectral CT

Purpose To explore the potential use of spectral CT in predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).Methods Forty patients who underwent hepatic resection for HCC were preoperatively examined with spectral CT during the arterial phase (AP) andportal venous phase (VP). Iodine concentration (IC) and water concentration(WC) in the lesions were measured and normalized to the aorta.Histopathological analyses confirmed the presence and absence of MVI. The postoperative specimens were performed for immunohistochemical staining to identify vascular endothelial growth factor (VEGF) and microvessel density(MVD). The two-sample t-test was used to compare quantitative parameters.Pearson's correlation analysis was carried out to determine if there were any linear associations between MVD or VEGF and spectral CT parameters.Results The histopathological results revealed that 24 HCCs were positive(21 men, 3 women) and the other 16 were negative (14 men, 2 women) for microvascular invasion. The MVD in positive group and negative group were 48.87 ± 17.32 and 32.62 ± 11.85, respectively, the differences were significant(t=-3.271, P < 0.05).The NIC in the AP (NIC-a) in positive group and negative group were 0.144 ±0.043 and 0.105 ±0.033,respectively, the differences were significant (t=-3.042, P < 0.05). VEGF, NIC in the PP and NWC in the two phase were not significantly different between the groups (P>0.05). There were moderate correlation between MVD and NIC-a (r=0.507, P<0.05).Conclusion Spectral CT imaging provides a noninvasive,quantitative technique for assessing tumor angiogenesis and predicting microvascular invasion of hepatocellular carcinoma.