Ultrasound-based Radiomics Analysis for Assessing Risk Factors Associated With Early Recurrence Following Surgical Resection of Hepatocellular Carcinoma

Objective: The aim of this study was to explore the value of ultrasound-based radiomics analysis for early recurrence after surgical resection of hepatocellular carcinoma (HCC).

Methods: This retrospective study included 127 patients who underwent primary surgical resection for HCC between October 2019 and November 2021. The patients were subsequently divided into training and validation sets (7:3 ratio). All patients received preoperative routine ultrasound and contrast-enhanced ultrasound examination, with postoperative pathological confirmation of HCC. Radiomics features were extracted from maximum section of a two-dimensional ultrasound image. The least absolute shrinkage and selection operation logistic regression algorithm with 10-fold cross-validation was used to establish ultrasonic radiomics features. Logistic regression modelling was used to build models based on clinical and ultrasonic features (model 1, clinical-ultrasonic model), radiomics signature (model 2, ultrasonic radiomics model), and the combination (model 3, clinical-ultrasonic-radiomics model). Then, a nomogram model was established to predict the risk of early recurrence, and the application value of nomogram through internal verification was evaluated.

Results: Model 3 showed optimal diagnostic performance in both training set (area under the curve [AUC], 0.907) and validation set (AUC, 0.925), followed by the model 1 in training set (AUC, 0.846) and validation set (AUC, 0.855), both above two models performed better than model 2 in training set (AUC, 0.751) and validation set (AUC, 0.702) (p < 0.05). In the training set and validation set of model 3, the sensitivity were 83.3%, 77.8%, the specificity ware 95.8%, 100.0% and the C-index were 0.791, 0.778.

Conclusion: The preoperative clinical-ultrasonic-radiomics model is anticipated to be a reliable tool for predicting the early recurrence of surgical resection of HCC.