Incremental value of radiomics-based heterogeneity to the existing risk criteria in predicting recurrence of hepatocellular carcinoma after liver transplantation

Pei Nie; Juntao Zhang; Wenjie Miao; Shaofeng Duan; Tongyu Wang; Ju Zhang; Jinyang Gu; Ning Wang; Ran Zhang; Ximing Wang; Guangjie Yang; Wei Rao; Zhenguang Wang

doi:10.1007/s00330-023-09591-3

Incremental value of radiomics-based heterogeneity to the existing risk criteria in predicting recurrence of hepatocellular carcinoma after liver transplantation

Eur Radiol. 2023 Sep;33(9):6608-6618. doi: 10.1007/s00330-023-09591-3. Epub 2023 Apr 4.

Authors

Pei Nie¹, Juntao Zhang², Wenjie Miao³, Shaofeng Duan², Tongyu Wang¹, Ju Zhang³, Jinyang Gu⁴, Ning Wang⁵, Ran Zhang⁶, Ximing Wang⁷, Guangjie Yang⁸, Wei Rao⁹, Zhenguang Wang¹⁰

Affiliations

¹ Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
² GE Healthcare, Precision Health Institution, Shanghai, China.
³ Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, Shandong, 266061, China.
⁴ Department of Transplantation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, 250021, China.
⁶ Huiying Medical Technology Co. Ltd, Beijing, China.
⁷ Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, Jinan, Shandong, 250021, China. wxming369@163.com.
⁸ Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, Shandong, 266061, China. ygj_2815@qdu.edu.cn.
⁹ Division of Hepatology, Liver Disease Center, Organ Transplantation Center, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, Shandong, 266061, China. qdfy_raowei@qdu.edu.cn.
¹⁰ Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, Shandong, 266061, China. wangzhenguang@qdu.edu.cn.

PMID: 37012548
DOI: 10.1007/s00330-023-09591-3

Abstract

Objectives: The aim of the study was to evaluate the association between the radiomics-based intratumoral heterogeneity (ITH) and the recurrence risk in hepatocellular carcinoma (HCC) patients after liver transplantation (LT), and to assess its incremental to the Milan, University of California San Francisco (UCSF), Metro-Ticket 2.0, and Hangzhou criteria.

Methods: A multicenter cohort of 196 HCC patients were investigated. The endpoint was recurrence-free survival (RFS) after LT. A CT-based radiomics signature (RS) was constructed and assessed in the whole cohort and in the subgroups stratified by the Milan, UCSF, Metro-Ticket 2.0, and Hangzhou criteria. The R-Milan, R-UCSF, R-Metro-Ticket 2.0, and R-Hangzhou nomograms which combined RS and the four existing risk criteria were developed respectively. The incremental value of RS to the four existing risk criteria in RFS prediction was evaluated.

Results: RS was significantly associated with RFS in the training and test cohorts as well as in the subgroups stratified by the existing risk criteria. The four combined nomograms showed better predictive capability than the existing risk criteria did with higher C-indices (R-Milan [training/test] vs. Milan, 0.745/0.765 vs. 0.677; R-USCF vs. USCF, 0.748/0.767 vs. 0.675; R-Metro-Ticket 2.0 vs. Metro-Ticket 2.0, 0.756/0.783 vs. 0.670; R-Hangzhou vs. Hangzhou, 0.751/0.760 vs. 0.691) and higher clinical net benefit.

Conclusions: The radiomics-based ITH can predict outcomes and provide incremental value to the existing risk criteria in HCC patients after LT. Incorporating radiomics-based ITH in HCC risk criteria may facilitate candidate selection, surveillance, and adjuvant trial design.

Key points: • Milan, USCF, Metro-Ticket 2.0, and Hangzhou criteria may be insufficient for outcome prediction in HCC after LT. • Radiomics allows for the characterization of tumor heterogeneity. • Radiomics adds incremental value to the existing criteria in outcome prediction.

Keywords: Hepatocellular carcinoma; Heterogeneity; Liver transplantation; Outcome; Radiomics.

Publication types

Multicenter Study

MeSH terms

Carcinoma, Hepatocellular* / diagnostic imaging
Carcinoma, Hepatocellular* / etiology
Carcinoma, Hepatocellular* / surgery
Humans
Liver Neoplasms* / diagnostic imaging
Liver Neoplasms* / etiology
Liver Neoplasms* / surgery
Liver Transplantation* / adverse effects
Neoplasm Recurrence, Local / pathology
Prognosis
Retrospective Studies

Abstract

Publication types

MeSH terms

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