MRI 减影技术评估系统治疗中晚期肝细胞癌效果、预测联合手术治疗后预后

Objective To explore the value of MRI subtraction technique（ST）for evaluating the efficacy of systemic therapy for advanced hepatocellular carcinoma（HCC） and predicting prognosis after combining with surgery. Methods Totally 35 patients with 39 HCC lesions who received systemic therapy + radical resection were retrospectively collected. Based on preoperative MRI， tumor activity ratio（recorded as tumor activity_ST）was obtained with ST， while tumor activity value（recorded as tumor activity_pathology）was obtained through postoperative pathology， and their correlation was analyzed. The patients were regularly followed up after surgery， and the survival data were recorded. Receiver operating characteristic （ROC） curve was drawn to evaluate the efficacy of tumor activity_ST for predicting patients’ survival status. Then the patients were divided into survival benefit group and no survival benefit group according to the cut-off value， and survival analysis was conducted. Results Tumor activity_ST was positively correlated with tumor activity_pathology（r=0. 900， P＜ 0. 001）. The median follow-up time was 32. 93 months， during which 8 patients died，and the median survival time was 29. 9 months. The area under the curve （AUC） of tumor activity_ST for predicting patients’survival status was 0. 67， and the cut-off value was 0. 36. Thirty patients with tumor activity_ST ＜ 0. 36 were enrolled in survival benefit group， while 5 patients ≥0. 36 were collected in no survival benefit group. The overall survival in survival benefit group was longer than that in no survival benefit group（P＜ 0. 001）. Conclusion MRI ST could be used to non-invasively evaluate the efficacy of systemic therapy for advanced HCC and predict prognosis after combining with surgery.