Computed Tomography Radiomics-Based Prediction of Microvascular Invasion in Hepatocellular Carcinoma.

Background: Due to the high recurrence rate in hepatocellular carcinoma (HCC) after resection, preoperative prognostic prediction of HCC is important for appropriate patient management. Exploring and developing preoperative diagnostic methods has great clinical value in treating patients with HCC. This study sought to develop and evaluate a novel combined clinical predictive model based on standard triphasic computed tomography (CT) to discriminate microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Methods: The preoperative findings of 82 patients with HCC, including conventional clinical factors, CT imaging findings, and CT texture analysis (TA), were analyzed retrospectively. All included cases were divided into MVI-negative (n = 33; no MVI) and MVI-positive (n = 49; low or high risk of MVI) groups. TA parameters were extracted from non-enhanced, arterial, portal venous, and equilibrium phase images and subsequently calculated using the Artificial Intelligence Kit. After statistical analyses, a clinical model comprising conventional clinical and CT image risk factors, radiomics signature models, and a novel combined model (fused radiomic signature) was constructed. The area under the curve (AUC) of the receiver operating characteristics (ROC) curve was used to assess the performance of the various models in discriminating MVI. Results: We found that tumor diameter and pathological grade were effective clinical predictors in clinical model and 12 radiomics features were effective for MVI prediction of each CT phase. The AUCs of the clinical, plain, artery, venous, and delay models were 0.77 (95% CI: 0.67-0.88), 0.75 (95% CI: 0.64-0.87), 0.79 (95% CI: 0.69-0.89), 0.73 (95% CI: 0.61-0.85), and 0.80 (95% CI: 0.70-0.91), respectively. The novel combined model exhibited the best performance, with an AUC of 0.83 (95% CI: 0.74-0.93). Conclusions: Models derived from triphasic CT can preoperatively predict MVI in patients with HCC. Of the models tested here, the novel combined model was most predictive and could become a useful tool to guide subsequent personalized treatment of HCC.

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for the Analysis of Microvascular Permeability in Peritumor Brain Edema of Fibrous Meningiomas.

INTRODUCTION: This study aims to analyze the permeability of intra- and peri-meningiomas regions and compare the microvascular permeability between peritumoral brain edema (PTBE) and non-PTBE using DCE-MRI. METHODS: This was a retrospective of patients with meningioma who underwent surgery. The patients were grouped as PTBE and non-PTBE. The DCE-MRI quantitative parameters, including volume transfer constant (Ktrans), rate constant (Kep), extracellular volume (Ve), and mean plasma volume (Vp), obtained using the extended Tofts-Kety 2-compartment model. Logistic regression analysis was conducted to explore the risk factor of PTBE. RESULTS: Sixty-three patients, diagnosed as fibrous meningioma, were included in this study. They were 17 males and 46 females, aged from 32 to 88 years old. Kep and Vp were significantly lower in patients with PTBE compared with those without (Kep: 0.1852 ± 0.0369 vs. 0.5087 ± 0.1590, p = 0.010; Vp: 0.0090 ± 0.0020 vs. 0.0521 ± 0.0262, p = 0.007), while there were no differences regarding Ktrans and Ve (both p > 0.05). The multivariable analysis showed that tumor size ≥10 cm3 (OR = 4.457, 95% CI: 1.322-15.031, p = 0.016) and Vp (OR = 0.572, 95%CI: 0.333-0.981, p = 0.044) were independently associated with PTBE in patients with meningiomas. CONCLUSION: DCE-magnetic resonance imaging·Meningioma·Blood vessel MRI can be used to quantify the microvascular permeability of PTBE in patients with meningioma.

Lymphoplasmacyte-rich meningioma with atypical cystic-solid feature: A case report.

BACKGROUND: Lymphoplasmacyte-rich meningioma (LPRM) is one of the rarest variants of meningioma and is classified as grade I (benign) tumor. It is characterized by abundant infiltrates of lymphocytes and plasma cells. Here, we report an extremely rare case of LPRM with an atypical imaging finding of multiple cysts around a solid mass. CASE SUMMARY: The patient was a 36-year-old man with intermittent headache, dizziness, and vomiting for 2 years. Computed tomography and magnetic resonance imaging presented a cystic solid mass in the right frontal lobe with heavy peritumoral edema and obvious contrast enhancement. The patient was treated with right frontotemporal craniotomy, and gross total resection of the tumor was achieved without adjuvant therapy. There was no clinical or neuroradiological evidence of recurrent or residual tumor for 3 years after initial surgery. CONCLUSION: LPRM is one of the rarest variants of meningioma. Although, the mass of this case had common features, multiple cysts with nonuniform size and thin wall around the solid part are uncommon imaging finding, increasing the rate of misdiagnosis. The definitive diagnosis of LPRM relies on histopathological findings.