Background: Hepatocellular carcinoma (HCC) is a serious health concern because of its high morbidity and mortality. The prognosis of HCC largely depends on the disease stage at diagnosis. Computed tomography (CT) image textural analysis is an image analysis technique that has emerged in recent years.
Objective: To probe the feasibility of a CT radiomic model for predicting early (stages 0, A) and intermediate (stage B) HCC using Barcelona Clinic Liver Cancer (BCLC) staging.
Methods: A total of 190 patients with stages 0, A, or B HCC according to CT-enhanced arterial and portal vein phase images were retrospectively assessed. The lesions were delineated manually to construct a region of interest (ROI) consisting of the entire tumor mass. Consequently, the textural profiles of the ROIs were extracted by specific software. Least absolute shrinkage and selection operator dimensionality reduction was used to screen the textural profiles and obtain the area under the receiver operating characteristic curve values.
Results: Within the test cohort, the area under the curve (AUC) values associated with arterial-phase images and BCLC stages 0, A, and B disease were 0.99, 0.98, and 0.99, respectively. The overall accuracy rate was 92.7%. The AUC values associated with portal vein phase images and BCLC stages 0, A, and B disease were 0.98, 0.95, and 0.99, respectively, with an overall accuracy of 90.9%.
Conclusion: The CT radiomic model can be used to predict the BCLC stage of early-stage and intermediate-stage HCC.
Keywords: BCLC staging system; computed tomography; hepatocellular carcinoma; radiomics.