An exploratory nomogram model with

Background: There are still difficulties in dividing patients into an microvascular invasion (MVI) high-risk and non-high-risk group among hepatocellular carcinoma (HCC) patients based on the pathology findings. This study investigated preoperative fluorine-18-fluorodeoxyglucose ( Methods: A retrospective analysis was conducted involving 79 HCC patients undergoing liver transplantation with preoperative Results: LASSO regression identified TMRmax and tumor diameter as significant factors that are associated with high-risk MVI. Multivariate analysis confirmed the independence of these two predictors: TMRmax [odds ratio (OR) =1.757, 95% confidence interval (CI): 1.124-2.746; P=0.01] and tumor diameter (OR =1.247, 95% CI: 1.067-1.456; P=0.005). ROC curve analysis indicated that a TMRmax ≥2.1 achieved a sensitivity of 70.27% and a specificity of 64.29% [area under the ROC curve (AUC) =0.716], while a tumor diameter ≥8.3 cm had a sensitivity of 51.35% and a specificity of 90.48% (AUC =0.729). The combined model demonstrated improved predictive performance (C-index =0.779, 95% CI: 0.672-0.865) with the nomogram demonstrating good calibration. Conclusions: TMRmax and tumor diameter may be closely associated with high-risk MVI in HCC. The exploratory model combining TMRmax and tumor diameter may help on preoperative risk stratification. Due to the small sample size from a single center, the results of this study warrant validation.