• Jae Seok Bae, Dong Ho Lee, Nam-Joon Yi, Kwang-Woong Lee, Kyung-Suk Suh, Haeryoung Kim, Kyung Bun Lee, and Yunhee Choi.
• Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
• Ann. Surg. 2022 Nov 1; 276 (5): e466-e473.

ObjectiveTo compare the performances of MRE and TE for predicting severe complications after HR in patients with HCC.Summary Of Background DataLSM may have the potential to predict outcomes after HR in HCC patients.MethodsConsecutive patients who underwent HR for HCC between 2017 and 2019 were retrospectively enrolled. Before HR, LSM was performed in all patients using both MRE and TE. All postoperative complications were assessed using the comprehensive complication index (CCI). Severe postoperative complications were defined as a CCI ≥26.2. The performances of MRE and TE for predicting high CCI and diagnosing liver fibrosis were compared using the area under the receiver-operating-characteristic curve (AUROC). Uni-/multivariable logistic regression analyses were used to identify factors associated with high CCI.ResultsAmong the 208 enrolled patients, 28 patients (13.5%) had high CCI. For detecting high CCI, MRE had an AUROC of 0.874 [95% confidence interval (CI), 0.821-0.916], which was significantly higher than the AUROC of TE (0.756; 95% CI, 0.692-0.813) ( P = 0.020). MRE outperformed TE in detecting fibrosis of ≥F2 (AUROC: 0.935 vs 0.767; P = 0.008), ≥F3 (AUROC: 0.902 vs 0.774; P = 0.001) and F4 (AUROC: 0.916 vs 0.767; P < 0.001). LSM by MRE was independently associated with high CCI (odds ratio, 4.207 per kPa; 95% CI, 1.862-9.504; P < 0.001), whereas LSM by TE was not.ConclusionsMRE better predicted severe postoperative complications than TE in HCC patients who underwent HR. LSM by MRE was independently associated with high CCI after HR.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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