title: Prediction of microvascular invasion of hepatocellular carcinoma: preoperative CT and histopathologic correlation.
abstract: OBJECTIVE
  The objective of our study was to prospectively investigate whether nonsmooth margins detected on multiphasic CT images correlate with the presence and location of microvascular invasion (MVI) in hepatocellular carcinoma (HCC).
  
  
  METHODS
  A total of 102 patients with preoperative CT findings of solitary HCC were prospectively enrolled. Tumor size, tumor capsule, tumor margins, and peritumoral enhancement on preoperative CT images were assessed. Histopathologic results including the following were also recorded: tumor differentiation; liver fibrosis score; presence or absence of MVI; and, if present, the location of MVI. Correlation between tumor margin on preoperative CT images and histopathologic location of MVI was determined.
  
  
  RESULTS
  Pathologic examination revealed MVI in 60 of the 102 HCC specimens. Although the results of the univariate analysis showed that tumor size, higher Edmondson-Steiner grade, and nonsmooth tumor margins were associated with MVI, multivariate analysis revealed that only nonsmooth margins correlated with the presence of MVI in HCC (p < 0.001). Of the 60 HCC specimens with histopathologic evidence of MVI, 40 exhibited focal nonsmooth margins. In addition, the locations of the nonsmooth margins and MVI were similar in 36 of the 40 specimens.
  
  
  CONCLUSIONS
  Nonsmooth tumor margins correlated with the histopathologic presence and location of MVI. Therefore, nonsmooth margins detected on multiphasic CT may be predictive of MVI in HCC.
authors.affiliation: 1 Department of Radiology, Chang-Hua Christian Hospital, Changhua City, Taiwan.
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Chou
authors.forename: Ran-Chou
authors.initials: RC
authors.lastname: Chen
authors.forename: Wei-Chan
authors.initials: WC
authors.lastname: Lin
authors.forename: Chih-Jan
authors.initials: CJ
authors.lastname: Ko
authors.forename: Chia-Bang
authors.initials: CB
authors.lastname: Chen
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009389:Neovascularization, Pathologic / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden
keywords: CT; hepatocellular carcinoma; microvascular invasion; tumor capsule; tumor margin