CT radiomics combined with serum parameters can effectively predict early recurrence after transcatheter arterial chemoembolization for liver cancer

SUN Zhigang; LEI Xuedi; MENG Tao; HU Yukang; ZHANG Ning; YANG Penghui; TONG Zhong

doi:10.12122/j.issn.1674-4500.2025.03.01

Abstract：Objective To develop a combined nomogram model based on enhanced CT imaging features and clinical indicators for predicting early recurrence(ER)in untreated intermediate-stage hepatocellular carcinoma(HCC)patients after transcatheter arterial chemoembolization(TACE),and to compare the performance of this model with radiomics and clinical models.Methods In this retrospective,two-center study,55 HCC patients who underwent enhanced CT before TACE at Affiliated Hefei First People's Hospital from February 2020 to February 2024 were randomly divided into training and validation groups using five-fold cross-validation.Clinical data,CT radiomics data,pathological data,and serum markers collected within one week before TACE were collected and evaluated for all patients.Radiomic features were selected using univariate rank sum tests and Spearman correlation analysis.Radscore was calculated based on the linear product of logistic regression model coefficients and feature values.Significant variables were identified using univariate and multivariate logistic regression,and a nomogram was constructed.The model's performance was assessed using ROC curves and decision curve analysis.Results In both the training and validation groups,the combined nomogram model had AUCs of 0.787(95%CI:0.52-1.05)and 0.847(95%CI:0.54-1.14),respectively,for predicting early recurrence after TACE.Univariate and multivariate regression analysis indicated that prothrombin time(P<0.05)was an independent serum marker associated with early recurrence after TACE.In both the training and validation groups,the AUC,accuracy,sensitivity,and specificity of the clinical model and the radiomic nomogram model alone were lower than those of the combined clinical-radiomic nomogram model.Decision curve analysis showed that the combined nomogram model had greater net benefit.Conclusion The proposed combined nomogram model has the potential to accurately predict early recurrence in HCC patients after TACE.