Enhancement Pattern Mapping for Early Detection of Hepatocellular Carcinoma in Patients with Cirrhosis

Figures & data

Figure 1 Patient selection process.

Table 1 Baseline Characteristics of Cases and Controls

Characteristics	Total No. of Patients (N = 147)	No. of Controls (n = 99)	No. of Cases (n = 48)	P value
Age at First Scan, y (%)*				0.89
< 40	4 (2.7)	2 (2.0)	2 (4.2)
41–50	15 (10.2)	10 (10.1)	5 (10.4)
51–60	65 (44.2)	46 (46.5)	19 (39.6)
61–70	58 (39.5)	38 (38.4)	20 (41.7)
>70	5 (3.4)	3 (3.0)	2 (4.2)
Sex, n (%)				0.74
Male	89 (60.5)	59 (59.6)	30 (62.5)
Female	58 (39.5)	40 (40.4)	18 (37.5)
Race, n (%)
Asian	5 (3.4)	1 (1.0)	4 (8.3)	0.06
Black/African American	8 (5.4)	6 (6.1)	2 (4.2)
White/Caucasian	129 (87.8)	90 (90.9)	39 (81.3)
Other	5 (3.4)	2 (1.4)	3 (2.0)
Ethnicity, n (%)				0.40
Hispanic	37 (25.2)	27 (27.3)	10 (20.8)
Non-Hispanic	110 (74.8)	72 (72.7)	38 (79.2)
Body Mass Index, n (%)				0.89
<18.5	0 (0.0)	0 (0.0)	0 (0.0)
18.5–24.9	26 (17.7)	18 (18.2)	8 (16.7)
25.0–29.9	40 (27.2)	27 (27.3)	13 (27.1)
30.0–34.9	52 (35.4)	33 (39.6)	19 (39.6)
35.0–39.9	23 (15.6)	16 (16.2)	7 (14.6)
>40 6	6 (4.1)	5 (5.1)	1 (2.1)
Cirrhosis Etiology, n (%)				0.82
Autoimmune Hepatitis	5 (3.4)	4 (4.0)	1 (2.1)
Alcoholic Liver Disease	13 (8.8)	9 (9.1)	4 (8.3)
Budd-Chiari Syndrome	3 (2.0)	2 (2.0)	1 (2.1)
Hemochromatosis	1 (0.7)	0 (0.0)	1 (2.1)
Hepatitis B Virus	6 (4.1)	4 (4.0)	2 (4.2)
Hepatitis C Virus	72 (49.0)	45 (45.5)	27 (56.3)
Metabolic Dysfunction-Associated Steatotic Liver Disease	20 (13.6)	15 (15.2)	5 (10.4)
Nonalcoholic Steatohepatitis	24 (16.3)	18 (18.2)	6 (12.5)
Primary Biliary Cholangitis	3 (2.0)	2 (2.0)	1 (2.1)
Diagnosis of Type II Diabetes Mellitus at First Scan, n (%)				0.70
No	101 (68.7)	67 (67.7)	34 (70.8)
Yes	46 (31.3)	32 (32.3)	14 (29.2)
		Controls (n = 99)	Cases (n = 48)
Median AFP, ng/mL (IQR)		3.7 (2.6–5.8)	6.5 (3.8–9.5)	0.003

Notes: *Median age was 60 (IQR 55–64) years for combined cohort, 59 (IQR 55–64) years for controls, and 60 years for cases (IQR 55–64).

Figure 2 Representative ROI used for CNR analysis of the image intensity on EPM (left) and on arterial phase MRI (right) with lesion indicated.

Figure 3 Box plots of EPM RMSD between observed lesions for pre-diagnostic and diagnostic scans in cases. (Left) On pre-diagnostic scans in cases, the median EPM RMSD observed was 0.44 for pre-malignant lesions and 0.22 for parenchyma. (Right) On diagnostic scans, the median EPM RMSD observed was 0.50 for HCC lesions and 0.22 for parenchyma. (Left and right).

Figure 4 ROC analysis of optimal threshold for discriminating case and control for pre-diagnostic and diagnostic time points. (a) In-sample ROC analysis for EPM RMSD in differentiating cases and controls on pre-diagnostic and single timepoint scans is shown. Similarly, (b) in-sample ROC analysis for EPM RMSD in differentiating cases and controls on diagnostic and single timepoint scans is shown. (c) Five-fold cross validation ROC analysis for EPM RMSD in differentiating cases and controls on pre-diagnostic and single timepoint scans is shown. Similarly, (d) Five-fold cross validation ROC analysis for EPM RMSD in differentiating cases and controls on diagnostic and single timepoint scans is shown.