Ultrasound radiomics in the prediction of microvascular invasion in hepatocellular carcinoma: A systematic review and meta-analysis

Purpose To systematically assess the clinical value of ultrasound radiomics in the prediction of microvascular invasion in hepatocellular carcinoma (HCC). Methods Relevant articles were searched in PubMed, Web of Science, Cochrane Library, Embase and Medline and screened according to the eligibility criteria. The quality of the included articles was assessed based on the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. After article assessment and data extraction, the diagnostic performance of ultrasound radiomics was evaluated based on pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR), and the area under the curve (AUC) was calculated by generating the ROC curve. Meta-analysis was performed using Stata 15.1, and subgroup analysis was conducted to identify the sources of heterogeneity. A Fagan nomogram was generated to assess the clinical utility of ultrasound radiomics. Results Five studies involving 1260 patients were included. Meta-analysis showed that ultrasound radiomics had a pooled sensitivity of 79% (95% CI : 75–83%), specificity of 70% (95% CI : 59–79%), PLR of 2.6 (95% CI : 1.9–3.7), NLR of 0.30 (95% CI : 0.23–0.39), DOR of 9 (95% CI : 5–16), and AUC of 0.81 (95% CI : 0.78–0.85). Sensitivity analysis indicated that the results were statistically reliable and stable, and no significant difference was identified during subgroup analysis. Conclusion Ultrasound radiomics has favorable predictive performance in the microvascular invasion of HCC and may serve as an auxiliary tool for guiding clinical decision-making.