Title:Hepatic Pecoma versus Hepatocellular Carcinoma In The Noncirrhotic Liver on
Gd-EOB-DTPA-Enhanced MRI: A Diagnostic Challenge
Volume: 20
Author(s): Ruixia Ma, Shi-Ting Feng, Meicheng-Chen, Jifei Wang, Zhi Dong and Xiaoqi Zhou*
Affiliation:
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangdong, China
Keywords:
Nomogram, MRI, Hepatic perivascular epithelioid cell tumors (PEComa), Hepatocellular carcinoma (HCC), Liver cirrhosis, PEComa.
Abstract:
Aim:
Hepatic perivascular epithelioid cell tumors (PEComa) often mimic hepatocellular carcinoma (HCC) in patients without cirrhosis. This study
aimed to develop a nomogram using imaging characteristics on Gd-EOB-DTPA-enhanced MRI and to distinguish PEComa from HCC in a noncirrhotic
liver.
Methods:
Forty patients with non-cirrhotic Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) were included in our study. A multivariate logistic
regression model was used to select significant variables to distinguish PEComa from HCC. A nomogram was developed based on the regression
model. The performance of the nomogram was assessed with respect to the ROC curve and calibration curve. Decision curve analysis (DCA) was
performed to evaluate the clinical usefulness of the nomogram.
Results:
Two significant predictors were identified: the appearance of an early draining vein and the T1D value of tumors. The ROC curve showed that the
area under the curve (AUC) of the model to predict the risk of PEComa was 0.91 (95% CI: 0.80~1) and showed that the model had high specificity
(92.3%) and sensitivity (88.9%). The nomogram incorporating these two predictors showed favorable calibration, which was validated using 1000
resampling procedures, and the corrected C-index of this model was 0.90. Furthermore, DCA analysis showed that the model had clinical
practicability.
Conclusion:
In conclusion, the nomogram model showed favorable predictive accuracy for distinguishing PEComa from HCC in non-cirrhotic patients and may
aid in clinical decision-making.
