Wu Meilong, Liu Liping, Wang Xiaojuan, Xiao Ying, Yang Shizhong, Dong Jiahong
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, Shenzhen People's Hospital, Shenzhen 518020, China.
The Second Clinical Medical College, Jinan University, Shenzhen 518020, China.
ILIVER. 2024 Feb 6;3(1):100079. doi: 10.1016/j.iliver.2024.100079. eCollection 2024 Mar.
Radiomic features extracted from preoperative contrast-enhanced computed tomography (CT) images have been shown to predict the prognosis of hepatocellular carcinoma (HCC). However, the prognostic role of radiomic features obtained from postoperative contrast-enhanced CT images of the remnant liver remains unclear. This study explored the prognostic value of radiomic features extracted from postoperative contrast-enhanced CT images in patients with HCC.
Robust radiomic features were obtained from postoperative contrast-enhanced CT images for 78 patients with primary HCC and used to construct a radiomics score. A clinical model and a combined model that integrated clinicopathological indicators and the radiomics score were established. The predictive performance of the model was assessed using the concordance index and net reclassification index.
The postoperative radiomics score for the remnant liver was an independent prognostic factor for disease-free survival (DFS) and overall survival (OS). The combined model was not inferior to the clinical model in predicting DFS but was superior in predicting OS. The net reclassification index confirmed that the combined model was more accurate and efficient in predicting OS and DFS. The radiomics score for DFS was significantly associated with tumor thrombus in the portal vein and the postoperative neutrophil-lymphocyte ratio. The radiomics score for OS was associated with multiple tumors, microvascular invasion, and tumor thrombus in the portal vein.
Postoperative contrast-enhanced CT radiomic features of the remnant liver were valuable prognostic indicators that could potentially reflect tumor burden and postoperative inflammatory status and provide more information for clinical decision-making.
术前对比增强计算机断层扫描（CT）图像提取的放射组学特征已被证明可预测肝细胞癌（HCC）的预后。然而，从肝切除术后残余肝脏的对比增强CT图像中获得的放射组学特征的预后作用仍不清楚。本研究探讨了从HCC患者术后对比增强CT图像中提取的放射组学特征的预后价值。
从78例原发性HCC患者的术后对比增强CT图像中获得稳健的放射组学特征，并用于构建放射组学评分。建立了整合临床病理指标和放射组学评分的临床模型和联合模型。使用一致性指数和净重新分类指数评估模型的预测性能。
残余肝脏的术后放射组学评分是无病生存期（DFS）和总生存期（OS）的独立预后因素。联合模型在预测DFS方面不劣于临床模型，但在预测OS方面更优。净重新分类指数证实联合模型在预测OS和DFS方面更准确、高效。DFS的放射组学评分与门静脉肿瘤血栓及术后中性粒细胞与淋巴细胞比值显著相关。OS的放射组学评分与多发肿瘤、微血管侵犯和门静脉肿瘤血栓相关。
残余肝脏的术后对比增强CT放射组学特征是有价值的预后指标，可能反映肿瘤负荷和术后炎症状态，并为临床决策提供更多信息。
