ArticleAbdominal radiology (New York)2026
Preoperative CT-derived extracellular volume fraction and volumetry can predict the post-hepatectomy liver failure and overall survival of patients with hepatocellular carcinoma after resection.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo develop and validate nomogram models based on preoperative CT-derived extracellular volume fraction (ECV) and volumetry for predicting post-hepatectomy liver failure (PHLF) and overall survival (OS) in hepatocellular carcinoma (HCC) patients.
methodsBetween January 2010 and June 2020, a total of 265 patients with resectable HCC were retrospectively enrolled and divided into a training cohort (n = 157) and an independent validation cohort (n = 108). CT-derived ECV, spleen volume (SV), liver volume (LV), future liver remnant volume (FLRV), body surface area (BSA) and ratios (SV/LV, FLRV/LV, LV/BSA, SV/BSA) were analyzed. Independent predictors for PHLF and OS were identified to construct nomograms. Model performance was evaluated using the concordance index (C-index), receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).
resultsOf 265 patients, 77 (29.0%) developed PHLF. Median follow-up was 63 months (49-66 months), with 1-/3-/5-year OS rates of 95.5%, 83.4%, and 68.7%. The nomogram for PHLF prediction, which integrated ECV (P < 0.001), FLRV/LV (P = 0.002), and SV/BSA (P = 0.014), demonstrated superior discrimination than conventional clinical models in both cohorts. The nomogram for OS prediction, combining ECV (P < 0.001) and AST (P = 0.006), also outperformed conventional clinical models in both cohorts.
conclusionsThe nomograms contributes to the preoperative prediction of PHLF (combining ECV, FLRV/LV, and SV/BSA) and OS (combining ECV and AST) in patients with resectable HCC.
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