MRI-based prediction of very early recurrence within 1 year after resection of HCC: An international cohort study

作者：Hong Wei, Subin Heo, Yang Yang, Mengsi Li, Fangfang Fu, Tianyi Xia, Seung Soo Lee, Eun Sun Choi, Riccardo Sartoris, Jules Grégory, Christine Ying Kwok, L Wang, Junhan Pan, Yanyan Zhang, Roberto Cannella, Zhenru Wu, Yingyi Wu, Xinyuan Jia, Yuanan Wu, Yi Wang, Ting Duan, Ting Yang, Liuji Sheng, Chongtu Yang, Shi-Ting Feng, Ming Kuang, Hui‐Chuan Sun, Yi Wang, Meiyun Wang, Shenghong Ju, Victoria Chernyak, Jean-Charles Nault, Stephen L. Chan, Jeong Min Lee, Cher Heng Tan, Wenzheng Li, Mustafa R. Bashir, Feng Chen, Maxime Ronot, Bin Song, Hanyu Jiang · 发表于：Journal of Hepatology · 年份：2026 · DOI：10.1016/j.jhep.2026.05.027 · 研究领域：Radiomics and Machine Learning in Medical Imaging、MRI in cancer diagnosis、Hepatocellular Carcinoma Treatment and Prognosis

BACKGROUND & AIMS: Very early recurrence (within one year after resection) of hepatocellular carcinoma (HCC) indicates aggressive tumor biology and poor prognosis, yet noninvasive prediction tools remain scarce. This study aimed to develop and validate MRI-based models for very early recurrence prediction and explore their biological underpinnings. METHODS: This international, multicenter cohort study retrospectively included 1811 consecutive patients who underwent curative-intent resection for single BCLC 0/A HCC and preoperative contrast-enhanced MRI or CT across 14 tertiary-care hospitals in China, South Korea, Singapore, France and the USA, and 40 eligible patients from TCGA-LIHC dataset. To predict 1-year recurrence-free survival (RFS), MRI for Very Early Recurrence Prediction (MERP) models were developed using preoperative variables alone (MERP-pre) or combining pre- and postoperative variables (MERP-post) in the derivation cohort (n=628), externally validated in Eastern (n=775) and Western (n=178) test cohorts, and extrapolated to a CT test cohort (n=230). Biological correlates were investigated using whole-exome and RNA sequencing. RESULTS: MERP-pre incorporated alpha-fetoprotein, tumor size, portal venous phase peritumoral hypoenhancement, and blood products in mass, while MERP-post replaced tumor size with microvascular invasion (MVI). Both models outperformed major staging systems and IMbrave050 criteria across all test cohorts (C-indexes, 0.685-0.790 vs. 0.524-0.6...