Value Of Texture Analysis Based On Enhanced MR Images For Predicting An Early Therapeutic Response To TACE Combined With HIFU Treatment In Hepatocellular Carcinoma

Objective: To evaluate the potential value of texture analysis(TA)based on contrast-enhanced magnetic resonance imaging(MRI)for predicting an early response of patients with hepatocellular carcinoma(HCC)who were treated with transcatheter arterial chemoembolization(TACE)combined with high-intensity focused ultrasound(HIFU)(TACE/HIFU).Methods: Patients with HCC(n=89)who underwent contrast-enhanced MRI at 1.5 T 1 week before and 1 week,1 month,and 3 months after TACE/HIFU were included in this retrospective study.Early responses were evaluated by two radiologists according to the Response Evaluation Criteria in Cancer of the Liver(RECICL).An independent Student's t-test and the Mann-Whitney U test were used to compare the TA parameters between the complete response(CR)group and the non-complete response(NCR)group.Logistic regression was used to determine the predictors of an early therapeutic response.Receiver operating characteristic(ROC)curve analyses was performed to assess the predictive value of the NCR lesions.Results: Among the 89 patients,58 showed CR and 31 showed NCR.Before TACE/HIFU,the CR group showed higher uniformity and energy but lower entropy than the NCR group based on the arterial phase and portal venous phase(P<0.05).After TACE/HIFU,the CR group showed higher uniformity and energy but lower entropy and skewness than the NCR group based on arterial phase(P<0.05).After TACE/HIFU the CR group showed higher uniformity but lower entropy and skewness than the NCR group based on portal venous phase(P<0.05).Logistic regression showed that preoperative uniformity and entropy,postoperative skewness,uniformity and entropy were predictors of an early response.ROC curve analysis suggested that preoperative entropy,postoperative skewness and entropy had the power to predict NCR.Conclusion: TA parameters based on contrast-enhanced MR images 1 week before and after TACE/HIFU may act as imaging biomarkers to predict an early response of patients with HCC.