[Discrimination of macrotrabecular-massive hepatocellular carcinoma based on fusion of multi-phase contrast-enhanced...

The macrotrabecular-massive (MTM) subtype of hepatocellular carcinoma (HCC) is a histological variant with higher malignant potential. Non-invasive preoperative identification of MTM-HCC is crucial for precise treatment. Current radiomics-based diagnostic models often integrate multi-phase features by simple feature concatenation, which may inadequately explore the latent complementary information between phases. This study proposes a feature fusion-based radiomics model using multi-phase contrast-enhanced computed tomography (mpCECT) images. Features were extracted from the arterial phase (AP), portal venous phase (PVP), and delayed phase (DP) CT images of 121 HCC patients. The fusion model was constructed and compared against the traditional concatenation model. Five-fold cross-validation demonstrated that the feature fusion model combining AP and PVP features achieved the best classification performance, with an area under the receiver operating characteristic curve (AUC) of 0.839. Furthermore, for any combination of two phases, the feature fusion model consistently outperformed the traditional feature concatenation approach. In conclusion, the proposed feature fusion model effectively enhances the discrimination capability compared to traditional models, providing a new tool for clinical practice.