Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2023; 29(26): 4186-4199
Published online Jul 14, 2023. doi: 10.3748/wjg.v29.i26.4186
Radiomics model based on contrast-enhanced computed tomography to predict early recurrence in patients with hepatocellular carcinoma after radical resection
Shu-Qun Li, Li-Li Su, Ting-Feng Xu, Li-Ying Ren, Dong-Bo Chen, Wan-Ying Qin, Xuan-Zhi Yan, Jia-Xing Fan, Hong-Song Chen, Wei-Jia Liao
Shu-Qun Li, Ting-Feng Xu, Li-Ying Ren, Wan-Ying Qin, Xuan-Zhi Yan, Jia-Xing Fan, Wei-Jia Liao, Laboratory of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
Li-Li Su, Department of Clinical Laboratory, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, Guangxi Zhuang Autonomous Region, China
Dong-Bo Chen, Hong-Song Chen, Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Disease, Beijing 100091, China
Author contributions: Li SQ, Su LL, Xu TF, and Ren LY contributed equally to this work; Liao WJ and Li SQ designed the study; Ren LY, Chen DB, Xu TF, and Su LL analyzed the data and wrote the manuscript; Yan XZ and Fan JX collected the data; Qin WY and Chen HS analyzed the images data; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81773148; Natural Science Foundation of Guangxi, No. 2018GXNSFDA138001; Program of Guangxi Zhuang Autonomous Region Health and Family Planning Commission, No. Z20210706; Guangxi Medical and Healthcare Appropriate Technology Development and Promotion and Application Projects, No. S2022132; Guangxi Natural Science Foundation, No. 2022JJA140009; and Guangxi Zhuang Autonomous Region Health and Family Planning Commission Self-funded of Scientific Research Project, No. Z20170812.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of the Affiliated Hospital of Guilin Medical University (Approval No. 2021WJWZC14).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Liao WJ has received fees for serving as a speaker, a professor for the Affiliated Hospital of Guilin Medical University; Liao WJ has received research funding from the National Natural Science Foundation of China.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at liaoweijia288@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Jia Liao, BM BCh, Professor, Laboratory of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Guilin Medical University, No. 15 Lequn Road, Xiufeng District, Guilin 541001, Guangxi Zhuang Autonomous Region, China. liaoweijia288@163.com
Received: February 11, 2023
Peer-review started: February 11, 2023
First decision: March 20, 2023
Revised: March 25, 2023
Accepted: June 6, 2023
Article in press: June 6, 2023
Published online: July 14, 2023
Processing time: 141 Days and 19.8 Hours
Abstract
BACKGROUND

Radical resection remains an effective strategy for patients with hepatocellular carcinoma (HCC). Unfortunately, the postoperative early recurrence (recurrence within 2 years) rate is still high.

AIM

To develop a radiomics model based on preoperative contrast-enhanced computed tomography (CECT) to evaluate early recurrence in HCC patients with a single tumour.

METHODS

We enrolled a total of 402 HCC patients from two centres who were diagnosed with a single tumour and underwent radical resection. First, the features from the portal venous and arterial phases of CECT were extracted based on the region of interest, and the early recurrence-related radiomics features were selected via the least absolute shrinkage and selection operator proportional hazards model (LASSO Cox) to determine radiomics scores for each patient. Then, the clinicopathologic data were combined to develop a model to predict early recurrence by Cox regression. Finally, we evaluated the prediction performance of this model by multiple methods.

RESULTS

A total of 1915 radiomics features were extracted from CECT images, and 31 of them were used to determine the radiomics scores, which showed a significant difference between the early recurrence and nonearly recurrence groups. Univariate and multivariate Cox regression analyses showed that radiomics scores and serum alpha-fetoprotein were independent indicators, and they were used to develop a combined model to predict early recurrence. The area under the receiver operating characteristic curve values for the training and validation cohorts were 0.77 and 0.74, respectively, while the C-indices were 0.712 and 0.674, respectively. The calibration curves and decision curve analysis showed satisfactory accuracy and clinical utilities. Kaplan-Meier curves based on recurrence-free survival and overall survival showed significant differences.

CONCLUSION

The preoperative radiomics model was shown to be effective for predicting early recurrence among HCC patients with a single tumour.

Keywords: Hepatocellular carcinoma; Contrast-enhanced computed tomography; Radiomics; Early recurrence

Core Tip: Hepatocellular carcinoma (HCC) is a growing health issue worldwide, ranking sixth in incidence and third in mortality among all cancers. Moreover, due to the high malignancy and suppressive immune microenvironment of HCC, there remain high recurrence and metastasis rates. Therefore, we developed a radiomics model based on preoperative contrast-enhanced computed tomography to evaluate early recurrence in HCC patients with a single tumour.