ArticleAbdominal radiology (New York)2026
Predicting advanced-stage recurrence in resected hepatocellular carcinoma using preoperative gadoxetic acid-enhanced MRI radiomics.
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
objectivesTo develop and validate a preoperative gadoxetic acid-enhanced MRI-based radiomics model for predicting the time to advanced-stage recurrence in patients undergoing resection for hepatocellular carcinoma (HCC). MATERIALS AND
methodsThis retrospective single-center study included patients with Barcelona Clinic Liver Cancer (BCLC) stage 0/A HCC who underwent resection between 2009 and 2014. Patients were temporally divided into training (n = 272; 2009-2011) and validation (n = 210; 2012-2014) cohorts. Time to advanced-stage recurrence was defined as the interval from resection to macrovascular invasion and/or extrahepatic metastasis. Two radiologists segmented tumors on hepatobiliary phase images, followed by 3-mm peritumoral expansion and propagation to co-registered dynamic T1- and T2-weighted images. After extraction of Image Biomarker Standardization Initiative-compliant features, a radiomics model was developed using least absolute shrinkage and selection operator (LASSO)-Cox regression. Model performance and inter-reader reproducibility of binary risk stratification were evaluated using the concordance index (C-index) and Cohen's kappa, respectively.
resultsFive-year advanced-stage recurrence occurred in 15% of the training (42/272) and validation (32/210) cohorts. In the validation cohort, the radiomics model yielded a C-index of 0.716 (95% CI, 0.631-0.801). This outperformed the preoperative BCLC (0.597; 95% CI 0.551-0.644) and Hong Kong Liver Cancer (0.594; 95% CI 0.516-0.672) staging systems, and was equivalent to the postoperative clinicopathological model (0.716; 95% CI 0.626-0.807). Radiomic-based risk stratification showed good inter-reader reproducibility (kappa = 0.757).
conclusionThe preoperative radiomics model outperformed staging systems and was comparable to the postoperative clinicopathological model in predicting advanced-stage recurrence, relying entirely on noninvasive data.
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