ArticleJournal of liver cancer2026
Prognostic value of automated computed tomography body composition in hepatocellular carcinoma: a volumetric versus single-slice comparison.
Article in Journal of liver cancer, 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
Background/Aims: To compare the prognostic value of fully automated volumetric versus single-slice computed tomography (CT)-derived body composition analysis for predicting overall survival in patients with newly diagnosed hepatocellular carcinoma (HCC). Methods: In this retrospective study of 448 patients with newly diagnosed HCC, deep-learning algorithm quantified volumetric (L1-L5) and single-slice (L3) skeletal muscle and adipose tissue metrics using CT images. Spearman correlation assessed the relationship between volumetric and single-slice body composition metrics. Cox proportional hazards models, adjusted for established clinical prognostic factors, were used to evaluate association between body composition parameters and overall survival. Harrell's C-index was used to compare prognostic performance of Cox models. Results: Strong correlations (correlation coefficient ≥0.82) were observed between volumetric and single-slice measurements for muscle attenuation, visceral fat index, and subcutaneous fat index, while muscle index demonstrated only moderate correlation (correlation coefficient= 0.50). Single-slice low muscle index (hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.15-2.31; P=0.006), single-slice low muscle attenuation (HR, 1.38; 95% CI, 1.01-1.88; P=0.045) and volumetric low muscle attenuation (HR, 1.42; 95% CI, 1.03-1.95; P=0.034) were identified as independent predictors of overall survival. Median follow-up was 6.6 years. The single-slice and volumetric models showed comparable discrimination (C-index, 0.816 vs. 0.817; P=0.11). Conclusion: Automated single-slice muscle parameters at the L3 level provide significant prognostic stratification in patients with hepatocellular carcinoma, establishing it as a viable, time-efficient tool for routine oncologic practice. In contrast, automated volumetric body composition assessment did not provide superior discrimination compared with the single-slice approach.
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