Quantified enhancement volume based on MRI as a prognostic biomarker for early recurrence in hepatocellular carcinoma

To investigate the association between MRI multi-phase enhancement volume and early recurrence in patients with hepatocellular carcinoma (HCC). This multicenter retrospective study included 532 HCC patients who underwent hepatectomy and were divided into an internal cohort (n=372) and an external cohort (n=160). We automatically measured multi-phase enhanced volume on MRI using artificial intelligence techniques, including arterial phase enhancement volume fraction (AP_EnVF), portal venous phase enhancement volume fraction (PV_EnVF), and delayed phase enhancement volume fraction (DP_EnVF). Lasso-Cox and multivariable Cox regression analyses were performed to identify independent predictors. Per 15% decrease in preoperative AP_EnVF, a quantitative MRI-derived imaging feature, was associated with a significantly increased risk of early recurrence: hazard ratio (HR) [95% confidence interval (CI)] was 1.63 (1.12–2.37; p = 0.015) in the internal cohort and 2.54 (1.18–5.47; p = 0.023) in the external cohort. However, PV_EnVF and DP_EnVF showed no significant predictive value (both p > 0.05). The AP_EnVF quantified by MRI was independently associated with early recurrence after hepatectomy in patients with HCC.