Title: Clinical and imaging features Preoperative evaluation of histological grade and
microvascular infiltration of hepatocellular carcinoma
Version: 1 Date: 08 Jun 2022
Reviewer:  Yutaka Midorikawa
Reviewer's report:
Comment on the manuscript cd04fc8d-4174-46c8-b1aa-5b23a260f89e by Zhang, et al.
Microvascular invasion (MVI) and tumor differentiation grade are one of the poor risk factors
after treatment of HCC. The authors predicted MVI and differentiation grade using MRI before
operation. The concept of the paper is intriguing, however, there are major concerns that need
to be addressed.
There are several questions and suggestions for corrections.
1) It has been reported that MVI and tumor differentiation grade are the predictors for the patients
undergoing resection for HCC. Then, it should be validated that survivals of patient who were
estimated having MVI or poorly differentiated grade were actually shorter compared with those
without MVI or highly differentiated grade HCC. There were no data and discussion from this
point.
2) Patients with multiple tumors were included in this study, however, there was no data about
the total number of tumors. If the patients had multiple tumors, which nodule was analyzed. Or
all tumors were subjects for this study, parameter should be the total number of nodules, not
“175 patients”.
3) Results were redundant, which should be more concise. The data can be understood if readers
see Tables.
4) Why prediction of MVI or tumor differentiation grade are necessary for the candidates
with HCC. If patients were preoperatively diagnosed as having these factors, does it affect the
operative procedures or indication of operation? This should be clearly discussed.
5) “Conclusions” are just a summary of Results. It should be, for example, “Preoperative
enhanced imaging is available to predict MVI and tumor differentiation grade of HCC”.
Title: Clinical and imaging features Preoperative evaluation of histological grade and
microvascular infiltration of hepatocellular carcinoma
Version: 1 Date: 08 Jun 2022
Reviewer:  Yutaka Midorikawa
Reviewer's report:
Comment on the manuscript cd04fc8d-4174-46c8-b1aa-5b23a260f89e by Zhang, et al.
Microvascular invasion (MVI) and tumor differentiation grade are one of the poor risk factors
after treatment of HCC. The authors predicted MVI and differentiation grade using MRI before
operation. The concept of the paper is intriguing, however, there are major concerns that need
to be addressed.
There are several questions and suggestions for corrections.
1) It has been reported that MVI and tumor differentiation grade are the predictors for the patients
undergoing resection for HCC. Then, it should be validated that survivals of patient who were
estimated having MVI or poorly differentiated grade were actually shorter compared with those
without MVI or highly differentiated grade HCC. There were no data and discussion from this
point.
2) Patients with multiple tumors were included in this study, however, there was no data about
the total number of tumors. If the patients had multiple tumors, which nodule was analyzed. Or
all tumors were subjects for this study, parameter should be the total number of nodules, not
“175 patients”.
3) Results were redundant, which should be more concise. The data can be understood if readers
see Tables.
4) Why prediction of MVI or tumor differentiation grade are necessary for the candidates
with HCC. If patients were preoperatively diagnosed as having these factors, does it affect the
operative procedures or indication of operation? This should be clearly discussed.
5) “Conclusions” are just a summary of Results. It should be, for example, “Preoperative
enhanced imaging is available to predict MVI and tumor differentiation grade of HCC”.
Please review this paper.
user
Title: Clinical and imaging features Preoperative evaluation of histological grade and
microvascular infiltration of hepatocellular carcinoma
Version: 1 Date: 08 Jun 2022
Reviewer:  Yutaka Midorikawa
Reviewer's report:
Comment on the manuscript cd04fc8d-4174-46c8-b1aa-5b23a260f89e by Zhang, et al.
Microvascular invasion (MVI) and tumor differentiation grade are one of the poor risk factors
after treatment of HCC. The authors predicted MVI and differentiation grade using MRI before
operation. The concept of the paper is intriguing, however, there are major concerns that need
to be addressed.
There are several questions and suggestions for corrections.
1) It has been reported that MVI and tumor differentiation grade are the predictors for the patients
undergoing resection for HCC. Then, it should be validated that survivals of patient who were
estimated having MVI or poorly differentiated grade were actually shorter compared with those
without MVI or highly differentiated grade HCC. There were no data and discussion from this
point.
2) Patients with multiple tumors were included in this study, however, there was no data about
the total number of tumors. If the patients had multiple tumors, which nodule was analyzed. Or
all tumors were subjects for this study, parameter should be the total number of nodules, not
“175 patients”.
3) Results were redundant, which should be more concise. The data can be understood if readers
see Tables.
4) Why prediction of MVI or tumor differentiation grade are necessary for the candidates
with HCC. If patients were preoperatively diagnosed as having these factors, does it affect the
operative procedures or indication of operation? This should be clearly discussed.
5) “Conclusions” are just a summary of Results. It should be, for example, “Preoperative
enhanced imaging is available to predict MVI and tumor differentiation grade of HCC”.
assistant