Prediction of recurrence of HCC after TACE using enhanced CT heterogeneity assessment

Abstract Purpose: To evaluate the value of enhanced computed tomography（CT）heterogeneity in predicting early recurrence of patients with hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Methods: Forty-seven HCC patients (40M/7F) were included in the study. Tumor histogram and texture analysis were performed on contrast-enhanced CT imaging prior to TACE. The clinical diagnosis of HCC at recurrent stages was based on the criteria of the American Association for the Study of Liver Diseases (AASLD) or biopsy. Two parameters of HCC heterogeneity (histogram and texture) were compared in the Early Recurrence (ER) and the Non-Early Recurrence (Non-ER) groups. Analysis was applied to both single-slice ROI and whole-tumor volumetric VOI. Receiver operating characteristic (ROC）was calculated to determine the ability of the parameters to differentiate between ER and non-ER groups. Results: 27 patients with ER and 20 patients with NER. The largest diameters of tumors in ER group were significantly larger than NER group( P＜0.001). Texture results for ROI and VOI analyses were similar. In the histogram analysis, the 50th percentile of pixel intensity predicted early recurrence with a sensitivity (Se) of 92.6%. In texture analysis, entropy, mean, and inhomogeneity were significantly associated with early recurrence( P＜0.05) but not skewness and kurtosis (P＞0.05). Inhomogeneity had the highest diagnostic specificity (95%). Conclusions: This study shows that CT histogram and texture features are significantly different in ER group from Non-ER Group.