A computed tomography radiogenomic biomarker predicts microvascular invasion and clinical outcomes in hepatocellular carcinoma

Abstract

Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is an independent predictor of poor outcomes following surgical resection or liver transplantation (LT); however, MVI currently cannot be adequately determined preoperatively. Radiogenomic venous invasion (RVI) is a contrast‐enhanced computed tomography (CECT) biomarker of MVI derived from a 91‐gene HCC "venous invasion" gene expression signature. Preoperative CECTs of 157 HCC patients who underwent surgical resection (N = 72) or LT (N = 85) between 2000 and 2009 at 3 institutions were evaluated for the presence or absence of RVI. RVI was assessed for its ability to predict MVI and outcomes. Interobserver agreement for scoring RVI was substantial among 5 radiologists (κ=0.705, PConclusion: RVI is a noninvasive radiogenomic biomarker that accurately predicts histologic MVI in HCC surgical candidates. Its presence on preoperative CECT is associated with early disease recurrence and poor overall survival and may be useful for identifying patients less likely to derive a durable benefit from surgical treatment.