Multiparametric MRI-based radiomics and clinical nomogram predicts the recurrence of hepatocellular carcinoma after postoperative adjuvant transarterial chemoembolization

作者：Xinyu Guo, Jingjing Song, Lingyi Zhu, Shuang Liu, Chaoming Huang, Lingling Zhou, Weiyue Chen, Guihan Lin, Zhongwei Zhao, Jianfei Tu, Minjiang Chen, Feng Chen, Liyun Zheng, Jiansong Ji · 发表于：BMC Cancer · 年份：2025 · DOI：10.1186/s12885-025-14079-y · 被引用次数：9 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Radiomics and Machine Learning in Medical Imaging

BACKGROUND: This study was undertaken to develop and validate a radiomics model based on multiparametric magnetic resonance imaging (MRI) for predicting recurrence in patients with hepatocellular carcinoma (HCC) following postoperative adjuvant transarterial chemoembolization (PA-TACE). METHODS: In this retrospective study, 149 HCC patients (81 for training, 36 for internal validation, 32 for external validation) treated with PA-TACE were included in two medical centers. Multiparametric radiomics features were extracted from three MRI sequences. Least absolute shrinkage and selection operator (LASSO)-COX regression was utilized to select radiomics features. Optimal clinical characteristics selected by multivariate Cox analysis were integrated with Rad-score to develop a recurrence-free survival (RFS) prediction model. The model performance was evaluated by time-dependent receiver operating characteristic (ROC) curves, Harrell's concordance index (C-index), and calibration curve. RESULTS: Fifteen optimal radiomic features were selected and the median Rad-score value was 0.434. Multivariate Cox analysis indicated that neutrophil-to-lymphocyte ratio (NLR) (hazard ratio (HR) = 1.49, 95% confidence interval (CI): 1.1-2.1, P = 0.022) and tumor size (HR = 1.28, 95% CI: 1.1-1.5, P = 0.001) were the independent predictors of RFS after PA-TACE. A combined model was established by integrating Rad-score, NLR, and tumor size in the training cohort (C-index 0.822; 95% CI 0.805-0.861), inte...