Can Cellular Differentiation and Microvascular Invasion in Hepatocellular Carcinoma be Predicted by Contrast-Enhanced Computed Tomography?

Objective The purpose of our study was to examine the contrast-enhanced computed tomography (CECT) characteristics of hepatocellular carcinoma (HCC) in explanted liver, the association between microvascular invasion (MVI) and cellular differentiation, and to predict the severity of HCC. Material and Methods: CECT images of 54 surgically proven HCCs were evaluated with abdominal radiologist. Our CECT protocol was composed of precontrast, arterial, portal and delayed venous phases. The radiologist analysed the CT images for; tumor size, tumor margin, presence of intratumoral vessels; presence of capsule; intratumoral fat accumulation; and macroinvasion. The imaging features were correlated with cellular differentiation and MVI using Fisher's exact test or the χ2 test. Results: The results of our study indicated that there was a significant inverse correlation between the presence of capsule and MVI (p<0,05) and the grade of HCC (p=0,001) while a significant positive correlation was observed between macroinvasion and the grade of HCC (p=0,02). Conclusion: Patients with cirrhosis and HCC will be better managed if imaging techniques can predict tumor and MVI grade prior to treatment without necessitating a sample. MVI can be used to decide on treatment strategies and offer a more precise prognosis. For the preoperative prediction of MVI and tumor grade, the CECT-observed incomplete tumor capsule and the macroinvasion are crucial.