Multiregional Radiomics to Predict Microvascular Invasion in Hepatocellular Carcinoma Using Multisequence MRI.

[OBJECTIVES] This study aimed to develop a multiregional radiomics-based model using multisequence MRI to predict microvascular invasion in hepatocellular carcinoma.

[METHODS] We enrolled 141 patients with hepatocellular carcinoma, including 61 with microvascular invasion, who were diagnosed between March 2017 and July 2022. Clinical data were compared using the Wilcoxon rank-sum test or χ 2 test. Patients were randomly divided into training (n=112, 80%) and test (n=29, 20%) data sets. Four MRI sequences-including T2-weighted imaging, T2-weighted imaging with fat suppression, arterial phase-contrast enhancement, and portal venous phase contrast enhancement-were used to build the radiomics model. The tumor volumes of interest were manually delineated, and the expand-5 mm and expand-10 mm volumes of interest were automatically generated. A total of 1409 radiomic features were extracted from each volume of interest. Feature selection was performed using the least absolute shrinkage and selection operator and Spearman correlation analysis. Three logistic regression models (Tumor, Tumor-Expand5, and Tumor-Expand10) were established based on the radiomic features. Model performance was assessed using receiver operating characteristic analysis and Delong's test.

[RESULTS] Maximum tumor diameter, hepatitis B virus DNA, and aspartate aminotransferase levels were significantly different between the groups. The Tumor-Expand5mm model exhibited the best performance among the 3 models, with areas under the curve of 0.90 and 0.84 in the training and test data sets.

[CONCLUSIONS] The Tumor-Expand5 model based on multisequence MRI shows great potential for predicting microvascular invasion in patients with hepatocellular carcinoma, and may further contribute to personal clinical decision-making.