Radiomics on gadoxetic acid-enhanced magnetic resonance imaging for prediction of postoperative early and late recurrence of single hepatocellular carcinoma

Purpose: To evaluate the usefulness of the radiomic model in predicting early (≤2 years) and late (>2 years) recurrence after curative resection in cases involving a single hepatocellular carcinoma (HCC) 2-5 cm in diameter using preoperative gadoxetic acid-enhanced magnetic resonance imaging (MRI), in comparison to the clinicopathologic model. Experimental design: This retrospective study included 167 patients with surgically resected and pathologically confirmed single HCC 2-5cm in diameter (n = 167, training set:validation set = 128:39) who underwent preoperative gadoxetic acid-enhanced MRI between January 2010 and December 2015. A radiomic model, a clinicopathologic model, and a combined clinicopathologic-radiomic (CCR) model were built using a random survival forest to predict disease-free survival (DFS) in the following conditions: early DFS vs. late DFS, dynamic phases, and the peritumoral area included in the segmentation. Results: The radiomic model showed a prognostic performance comparable to the clinicopathologic model only with 3 mm peritumoral border extension (c-index difference [radiomic-clinicopathologic], -0.021, P = 0.758). The CCR model with the 3 mm border extension showed the highest c-index value but no statistically significant improvement over the clinicopathologic model (CCR, 0.716 [0.627-0.799]; clinicopathologic model, 0.696 [0.557-0.799]). Conclusion: The prognostic value of the preoperative radiomic model with 3 mm border extension showed comparable performance to that of the postoperative clinicopathologic model for predicting DFS of early recurrence of HCC using gadoxetic acid-enhanced MRI. This suggests the importance of including peritumoral changes in the radiomic analysis of HCC.

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