Development of a deep learning-based auto-segmentation algorithm for hepatocellular carcinoma (HCC) and application...

Automatic segmentation has recently been developed to yield objective data. Prediction of microvascular invasion (MVI) of hepatocellular carcinoma (HCC) using radiomics has been reported.

To develop a deep learning-based auto-segmentation algorithm (DL-AS) for the detection of HCC and to predict MVI using computed tomography (CT) texture analysis.

We retrospectively collected training data from 249 patients with HCC and validation set from 35 patients. Lesions of the training set were manually drawn by radiologist, in the delayed phase. 2D U-Net was selected as the DL architecture. Using the validation set, one radiologist manually drew 2D and 3D regions of interest twice, and the developed DL-AS was performed twice with a one-month time interval. The reproducibility was calculated using intraclass correlation coefficients (ICC). Logistic regression was performed to predict MVI.

ICC was in the range of 0.190-0.998/0.341-0.997 in the manual 3D/2D segmentation. In contrast, it was perfect in 3D/2D using DL-AS, with a success rate of 88.6% for the detection of HCC. For predicting MVI, sphericity was a significant parameter (odds ratio <0.001; 95% confidence interval <0.001-0.206; P = 0.020) for predicting MVI using 2D DL-AS. However, 3D DL-AS segmentation did not yield a predictive parameter.

The auto-segmentation of HCC using DL-AS provides perfect reproducibility, although it failed to detect 11.4% (4/35). However, the extracted parameters yielded different important predictors of MVI in HCC. Sphericity was a significant predictor in 2D DL-AS and 3D manual segmentation, while discrete compactness was a significant predictor in 2D manual segmentation.