MRI-Based Score to Predict Retreatment Response for Viable Hepatocellular Carcinomas After Transarterial...

Area of Science:

• Radiology and Imaging
• Oncology
• Hepatology

Background:

• Predicting treatment response in hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) is crucial for personalized patient management.
• Viable tumor imaging characteristics post-TACE are key indicators for assessing treatment efficacy and prognosis.

Purpose of the Study:

• To develop and validate an MRI-based prediction model for assessing viable tumor response to TACE in HCC patients.
• To correlate the prediction model's performance with patient survival outcomes.

Main Methods:

• Retrospective analysis of HCC patients with viable tumors 1 month post-TACE, using contrast-enhanced MRI at baseline, 1 month, and 6 months.
• Development of lesion- and patient-level prediction models (VITAL and VITAL-P) using logistic regression on training (n=167) and test (n=59) sets.
• External validation using data from a prospective clinical trial.

Main Results:

• The VITAL model, incorporating diffusion restriction, peritumoral hyperenhancement, heterogeneity, and mural nodule absence, achieved AUCs of 0.821 (training) and 0.733 (test).
• The VITAL-P score integrated tumor size and number with the VITAL score.
• High-risk patients (VITAL-P ≥ 16) showed significantly shorter overall survival and progression-free survival.

Conclusions:

• The developed MRI-based VITAL model effectively predicts 6-month retreatment response in viable post-TACE HCC.
• The VITAL model and VITAL-P score demonstrate strong predictive power for HCC treatment response and correlate with patient prognosis.