ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1623670
This article is part of the Research TopicHepatocellular Carcinoma: From Bench to BedsideView all 9 articles
Differentiation of AFP-negative hepatocellular carcinoma from other intrahepatic malignant lesions by a noninvasive predictive model based on Sonazoid contrast-enhanced ultrasound
Provisionally accepted
- 1First Hospital of Shanxi Medical University, Taiyuan, China
- 2Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Objectives: This study aimed to develop and validate a non-invasive predictive model, which was a reliable nomogram to accurately differentiate AFPN-HCC from other intrahepatic malignant lesions.Methods: This study enrolled 165 patients with malignant focal liver lesions, including AFPN-HCC (n=85) and other intrahepatic malignant lesions (n=80). Data were analyzed to screen for risk factors phase by using LASSO regression as well as univariate and multivariate logistic regression analysis. We constructed a model and developed a nomogram. Then using the area under the curve, Hosmer-Lemeshow test, calibration curves, decision curve analysis, and 1,000 bootstraps to assess and internally validate the model performance. We calculated the optimal threshold, sensitivity, specificity, positive and negative predictive value, and accuracy of the prediction model.Results: LASSO and multivariate logistic regression analyses indicated that tumor number, necrosis in tumor, arterial phase enhancement pattern, arterial phase perfusion velocity, and Kupffer phase degree of washout were the significant predictors to differentiate AFPN-HCC from OM. The AUC was 0.886, and the AUC of internal validation was 0.865. The optimal critical value of the predicted value was 0.524, with a sensitivity of 82.35%, specificity of 85.00%, positive predicted value of 85.37%, negative predicted value of 81.93%, and an accuracy of 83.64%. The P value of the Hosmer-Lemeshow test was 0.592. The calibration plots showed a high concordance of prediction .The decision curve analysis showed excellent net benefits.Conclusion: Our nomogram has excellent discrimination, calibration and clinical utility by combining SCEUS and clinical features, which may help clinicians improve the diagnostic performance for AFPN-HCC, contributing to individualized treatment.
Keywords: AFP-negative, Hepatocellular Carcinoma, contrast-enhanced ultrasound, Sonazoid, nomogram
Received: 06 May 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Zhang, Liu, Wang, Song, Fan, Liang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ping Liang, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
Liping Liu, First Hospital of Shanxi Medical University, Taiyuan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.