Prediction of 2-year PFS survival rate in hepatocellular carcinoma patients before TACE:based on different peritumoral radiomics of enhanced MRI

GUAN Qinglong; ZHANG Haixiao; REN Weixin

doi:10.12122/j.issn.1674-4500.2025.05.04

Abstract：Objective To explore the construction of different peritumoral prediction models based on enhanced MRI radiomics,and to predict the 2-year PFS survival rate of hepatocellular carcinoma patients before transarterial chemoembolization.Methods A total of 201 patients who received transarterial chemoembolization(TACE)treatment in interventional radiology center from the First Affiliated Hospital of Xinjiang Medical University from January 2021 to January 2023 were retrospectively collected.Patients included in the study underwent 3.0T enhanced MRI scan of upper abdomen one week before TACE.Based on the images of arterial phase,portal vein phase and delayed phase of enhanced MRI,the tumor region of interest(ROI)was delineated,and the tumor was expanded by 2,4,6 mm equidistantly,and the histological model of intra-tumor and different tumor weeks was constructed:intratumoral+peritumoral 2 mm model,intratumoral+peritumoral 4 mm model,intratumoral+peritumoral 6 mm model,Nomogram model.The effectiveness of the above model to understand the independent risk factors affecting prognosis and the prediction of survival rate were evaluated.Results In the training corhort and test corhort,the AUC efficiency of intra-tumor+peritumoral 6mm model was 0.997 and 0.966,respectively,and its intra-tumor+peritumoral 6mm model was better than intra-tumor+peritumoral 2 mm and 4 mm models.Combined with Nomogram model,intra-tumor+peritumoral 6 mm model showed good clinical predictive value;COX survival analysis showed that the predicted probability of intra-tumor+peritumoral 6 mm was an independent risk factor for PFS.Kaplan-Meier curve survival analysis showed that the prediction probability of intra-tumor+peritumoral 6 mm model was a risk factor affecting the prognosis(P<0.05),the median PFS in the high-risk group was 14.8 months(P<0.001)in the training corhort and the median PFS in the risk group was 12 months(P=0.001)in the test corhort.Conclusion The intra-tumor+peritumoral 6mm model based on enhanced MRI radiomics has good clinical application value in predicting the 2-year PFS survival rate before TACE,and it can become a new imaging biomarker in the future.