# Evaluation of hepatic functional reserve of hepatocellular carcinoma (≤ 5 cm) by liver shear wave velocity combined with multiple parameters

## TL;DR

This study shows that combining liver stiffness measurements with blood markers can effectively assess liver function in patients with small liver cancer.

## Contribution

A novel multiparametric model combining liver shear wave velocity with albumin and prothrombin time improves hepatic functional reserve assessment.

## Key findings

- The multiparametric model achieved an AUC of 0.913 for predicting hepatic functional reserve.
- LSWV combined with ALB and PT showed high sensitivity and specificity (0.763 and 0.926, respectively).
- Consistency testing confirmed strong predictive effectiveness with a Kappa value of 0.655.

## Abstract

Normal hepatic functional reserve is the key to avoiding liver failure after liver surgery. This study investigated the assessment of hepatic functional reserve using liver shear wave velocity (LSWV) combined with biochemical indicators, tumor volume, and portal vein diameter.

In this single-center prospective study, a total of 123 patients with hepatocellular carcinoma (HCC) were divided into a test group (n=92) and a validation group (n=31). All patients were Child-Pugh grade A. The indocyanine green retention rate at 15 min (ICG-R15), liver shear wave velocity (LSWV), portal vein diameter (Dpv), alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GGT), albumin (ALB), prothrombin time (PT), and also liver tumor volume (maximum diameter ≤5 cm) were measured. In the test group, multiple parameters were used to evaluate hepatic functional reserve, and the multiparametric model was established. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic performance of the multiparametric model. In the validation group, the predictive effectiveness of the multiparametric model was analyzed using consistency tests.

It was revealed that LSWV, ALB, and PT were statistically significant in evaluation of the hepatic functional reserve (P<0.05). The multiparametric model was formulated as follows: Y= -18.954 + 9.726*LSWV-0.397*ALB+2.063*PT. The value of the area under the curve (AUC) for the multiparametric model was 0.913 (95% confidence interval (CI): 0.835-0.962, P< 0.01), with a cutoff value of 16.656 (sensitivity, 0.763; specificity, 0.926). The Kappa value of consistency testing was 0.655 (P<0.01).

LSWV combined with ALB and PT exhibited a high predictive effectiveness for the assessment of hepatic functional reserve, assisting the clinical diagnosis and management of liver diseases.