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Abstract：
Owing to advances in diagnosis and treatment methods over past decades, a growing number of early-stage hepatocellular carcinoma (HCC) diagnoses has enabled a greater of proportion of patients to receive curative treatment. However, a high risk of early recurrence and poor prognosis remain major challenges in HCC therapy. Microvascular invasion (MVI) has been demonstrated to be an essential independent predictor of early recurrence after curative therapy. Currently, biopsy is not generally recommended before treatment to evaluate MVI in HCC according clinical guidelines due to sampling error and the high risk of tumor cell seeding following biopsy. Therefore, the postoperative histopathological examination is recognized as the gold standard of MVI diagnosis, but this lagging indicator greatly impedes clinicians in selecting the optimal effective treatment for prognosis. As imaging can now noninvasively and completely assess the whole tumor and host situation, it is playing an increasingly important role in the preoperative assessment of MVI. Therefore, imaging criteria for MVI diagnosis would be highly desirable for optimizing individualized therapeutic decision-making and achieving a better prognosis. In this review, we summarize the emerging image characteristics of different imaging modalities for predicting MVI. We also discuss whether advances in imaging technique have generated evidence that could be practice-changing and whether advanced imaging techniques will revolutionize therapeutic decision-making of early-stage HCC.
摘要：
由于过去几十年来诊断和治疗方法的进步，越来越多的早期肝细胞癌(HCC)诊断使更多比例的患者能够接受治愈性治疗.然而,早期复发的高风险和不良预后仍然是HCC治疗的主要挑战.微血管侵犯（MVI）已被证明是治愈性治疗后早期复发的重要独立预测因素。目前,由于抽样误差和活检后肿瘤细胞接种的高风险，通常不建议在治疗前进行活检以根据临床指南评估HCC中的MVI。因此,术后组织病理学检查是公认的MVI诊断的金标准,但这一滞后指标极大地阻碍了临床医生为预后选择最佳有效治疗方法.由于成像现在可以无创和完全评估整个肿瘤和宿主的情况，在MVI的术前评估中发挥着越来越重要的作用。因此,MVI诊断的影像学标准对于优化个性化治疗决策和实现更好的预后非常理想.在这次审查中,我们总结了用于预测MVI的不同成像方式的新兴图像特征。我们还讨论了成像技术的进步是否已经产生了可以改变实践的证据，以及先进的成像技术是否会彻底改变早期HCC的治疗决策。
