Clinical application of preoperative shear wave dispersion for prediction of post liver failure in patients with hepatocellular carcinoma after hepatectomy

Article type: Research Article

Authors: Wang, Kun^{a; b} | Zhu, Yuli^{a; c; 1} | Bao, Jingwen^{d; 1} | Zhu, Zheng^e | Dong, Yi^f | Han, Hong^{a; c} | Wang, Wenping^{a; c; g; *}

Affiliations: [a] Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China | [b] Department of Ultrasound, Binzhou Medical University Hospital, Binzhou, China | [c] Shanghai Institute of Medical Imaging, Shanghai, China | [d] School of Medical Science, Hexi University, Zhangye, China | [e] Department of Ultrasound, The First People’s Hospital of Taicang, Taicang, China | [f] Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China | [g] Institute of Ultrasound Medicine and Engineering, Fudan University, Shanghai, China

Correspondence: [*] Corresponding author: Prof. Dr. Wen-Ping Wang, Department of Ultrasound, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. Tel.: +86 021 64041990 2474; E-mail: puguang61@126.com.

Note: [1] These authors contributed equally to the manuscript.

Abstract: OBJECTIVE:The aim in this study was to determine the efficacy of shear wave dispersion (SWD) technique for the prediction of post hepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma after hepatectomy and develop an SWD based risk prediction model. METHODS & MATERIALS:We prospectively enrolled 205 consecutive patients who were scheduled to undergo hepatectomy for hepatocellular carcinoma (HCC), pre-operative SWD examination, laboratory data and some other clinicopathological tests were collected. The risk factors of PHLF were identified according to univariate and multivariate analysis, a predictive model was established based on logistic regression analyses. RESULTS:SWD examination was successfully performed in 205 patients. PHLF occurred in 51 patients (24.9%), including 37/11/3 patients with Grade A/B/C, respectively. There was a high correlation between SWD value of liver and liver fibrosis stage (r = 0.873, p < 0.05). Patients with PHLF has a higher median SWD value of liver than patients without PHLF [17.4 vs 14.7 (m/s)/kHz, p < 0.05]. The SWD value of liver, total bilirubin (TB), international normalized ratio of prothrombin time (INR) and splenomegaly were significantly related to PHLF based on the multivariate analysis. A new prediction model (PM) for PHLF was established (PM = –12.918 + 0.183× SWD + 6.668× INR +0.100×TB+1.240×splenomegaly). The optimal cutoff value of SWD for predicting PHLF was 16.7 (m/s)/kHz. The area under the curve (AUC) of the PM for PHLF was 0.833, which was higher than that of SWD, INR, Forns, FIB4, APRI (p < 0.005, respectively). CONCLUSION:SWD is a promising and reliable method for PHLF prediction in patients with HCC who were undergoing hepatectomy. Compared with SWD, Forns, APRI and FIB-4, PM demonstrate better efficacy for preoperative PHLF prediction.

Keywords: Keywords Hepatocellular carcinoma, shear wave dispersion, post hepatectomy liver failure

DOI: 10.3233/CH-221662

Journal: Clinical Hemorheology and Microcirculation, vol. 85, no. 3, pp. 223-234, 2023