Application of MRI-based radiomics model in predicting the tumor response in patients with advanced hepatocellular carcinoma after transcatheter arterial chemoembolization / 介入放射学杂志

ABSTRACT

Objective To develop a nomogram model based on the clinical features and the radiomics texture analysis of multimodal magnetic resonance imaging(MRI),so as to predict the tumor response in patients with advanced hepatocellular carcinoma(HCC)3 months after receiving transcatheter arterial chemoembolization(TACE).Methods A total of 105 patients with advanced HCC,whose diagnosis was pathologically-confirmed at the Suzhou Municipal Ninth People's Hospital between January 2017 and December 2021,were enrolled in this study.The patients were randomly divided into training group(n=63)and verification group(n=42).Before chemotherapy,T1WI,T2WI,dynamic contrast-enhanced(DCE)scan,and diffusion-weighted imaging(DWI)were performed by using a 3.0T MRI scanner.A.K.software was used to extract the texture.Three months after chemotherapy,according to the modified Response Evaluation Criteria in Solid Tumors(mRECIST)the patients were divided into response group(n=63)and non-response group(n=42).Results Compared with the response group,in the non-response group the percentage of Child-Pugh grade B and BCLC stage C was obviously higher and the serum alpha fetoprotein(AFP)level was remarkably elevated(P＜0.05).A.K.software extracted 396 MRI texture features,and LASSO regression analysis screened out 6 optimal predictors.The radiation score(Rad-score)was calculated by ROC.The AUC of Rad-score for predicting tumor non-response after TACE by ROC in the training group and verification group were 0.842 and 0.803 respectively.Multivariate logistic regression model analysis showed that AFP≥50 ng/mL(OR=1.568,95%CI=1.234-1.902,P=0.003),Child-Pugh grade B(OR=1.754,95%CI=1.326-2.021,P=0.001),BCLC stage C(OR=1.847,95%CI=1.412-2.232,P=0.001)and Rad-score(OR=2.023,95%CI=1.569-2.457,P＜0.001)were the independent risk factors for tumor non-response.Clinico-radiomics combination had the highest AUC value for predicting tumor non-response.The correction curve showed that the nomogram model had a good agreement.Conclusion The quantitative score of radiomics texture analysis of multimodal MRI has a certain value in predicting tumor non-response in advanced HCC patients 3 months after TACE,and the nomogram model,which is constructed if combined with clinical factors,carries good practical potential.(J Intervent Radiol,2024,32:63-68)