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Purpose The aim of this study was to develop an integrated model that combines clinical-radiologic and radiomics features based on gadoxetic acid-enhanced MRI for preoperative evaluating of vessels encapsulating tumour clusters (VETC) patterns in hepatocellular carcinoma (HCC). Methods This retrospective study encompassed 234 patients who underwent surgical resection. Among them, 101 patients exhibited VETC-positive HCC, while 133 patients displayed VETC-negative HCC. Volumes of interest were manually delineated for entire tumour regions in the arterial phase (AP), portal phase (PP), and hepatobiliary phase (HBP) images. Independent predictors for VETC were identified through least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression analysis, utilising radiomics-AP, PP, HBP, along with 24 imaging features and 19 clinical characteristics. Subsequently, the clinico-radiologic model, radiomics model, and integrated model were established, with a nomogram visualising the integrated model. The performance for VETC prediction was evaluated using a receiver operating characteristic curve. Results The integrated model, composed of 3 selected traditional imaging features (necrosis or severe ischemia OR=2. 457, peripheral washout OR=1. 678, LLRAP (Lesion to liver ratioAP) OR=0. 433 and radiomics-AP OR=2. 870, radiomics-HBP OR=2. 023, radiomics-PP OR=1. 546), showcased good accuracy in predicting VETC patterns in both the training (AUC=0. 873, 95% confidence interval CI: 0. 821-0. 925) ) and validation (AUC=0. 869, 95% CI: 0. 789-0. 950) cohorts. Conclusion This study established an integrated model that combines traditional imaging features and radiomic features from gadoxetic acid-enhanced MRI, demonstrating good performance in predicting VETC patterns.
Zhang et al. (Tue,) studied this question.