MRI-Based Models Using Habitat Imaging for Predicting Distinct Vascular Patterns in Hepatocellular Carcinoma

To develop two distinct models for predicting microvascular invasion (MVI) and vessels encapsulating tumor clusters (VETC) based on habitat imaging, and to integrate these models for prognosis assessment.

In this multicenter retrospective study, patients from two different institutions were enrolled and categorized for MVI (n=295) and VETC (n=276) prediction. Tumor and peritumoral regions on hepatobiliary phase images were segmented into subregions, from which all relevant features were extracted. The MVI and VETC predictive models were constructed by analyzing these features using various machine learning algorithms, and classifying patients into high-risk and low-risk groups. Cox regression analysis was utilized to identify risk factors for early recurrence.

The MVI and VETC prediction models demonstrated excellent performance in both the training and external validation cohorts (AUC: 0.961 and 0.838 for MVI; 0.931 and 0.820 for VETC). Based on model predictions, patients were classified into high-risk group (High-risk MVI/ High-risk VETC), medium-risk group (High-risk MVI/Low-risk VETC or Low-risk MVI/High-risk VETC), and low-risk group (Low-risk MVI/Low-risk VETC). Multivariable Cox regression analysis revealed that risk group, number of tumors, and gender were independent predictors of early recurrence.

Models based on habitat imaging can be used for the preoperative, noninvasive prediction of MVI and VETC, offering valuable stratification and diagnostic insights for HCC patients.