MRI-based radiomics and molecular classification of hepatocellular carcinoma — is there a correlation between them?

Abstract

Introduction: Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumor, usually developing in the context of chronic liver disease, most commonly associated with hepatitis B (HBV) or C (HCV) infection, alcohol use, or metabolic syndrome. Hepatocellular carcinoma is a very heterogeneous cancer, both at the histological and molecular level. According to recent scientific studies based on gene expression profiling, regardless of the nomenclature used by different authors, HCC can be divided into 2 main subgroups: the non-proliferative type and the proliferative type.Purpose. A review and analysis of the available foreign literature on the textural analysis of magnetic resonance imaging in noninvasive prediction of molecular classification and molecular structure of hepatocellular carcinoma.Material and methods. We searched for scientific publications and clinical guidelines in the PubMed information and analytical system for 2016–2021 using the keywords: «MRI», «radiomics», «texture analysis», «radiogenomics», «HCC», «proliferative», «nonproliferative», «molecular». After excluding studies devoted to technical aspects and the description of individual clinical observations, 16 articles were selected for analyzes.Results. The presented review has demonstrated the broad possibilities and prospects of the use of texture analysis of magnetic resonance imaging in the study of hepatocellular cancer, including the first results in the study of molecular characteristics (signatures) of this tumor. Correlation of textural characteristics with the expression of genes of immunotherapeutic targets CTLA-4 and PD-1 was shown, and a correlation was also shown between ring enhancement of a tumor in the arterial phase by MRI with gadoxetic acid (hepatospecific contrast agent) and proliferative HCC. Texture analysis scores were the predominant independent predictor of microvascular invasion, which was the main independent risk factor for postoperative recurrence.Conclusion. Although texture analysis in the study of HCC is an actively developing field, further study of the structure of this tumor at the molecular level is necessary to develop an personalized treatment, supplement or replace tumor biopsy, as well as to develop new prognostic biomarkers in patients with HCC.