Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2022; 28(20): 2176-2183
Published online May 28, 2022. doi: 10.3748/wjg.v28.i20.2176
Radiomics for the detection of microvascular invasion in hepatocellular carcinoma
Kun Lv, Xin Cao, Peng Du, Jun-Yan Fu, Dao-Ying Geng, Jun Zhang
Kun Lv, Xin Cao, Peng Du, Jun-Yan Fu, Dao-Ying Geng, Jun Zhang, Department of Radiology, Huashan Hospital, Fudan University, Shanghai 200040, China
Xin Cao, Dao-Ying Geng, Jun Zhang, Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai 200040, China
Xin Cao, Dao-Ying Geng, Jun Zhang, Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Research, Science and Technology Commission of Shanghai Municipality, Shanghai 200040, China
Xin Cao, Dao-Ying Geng, Jun Zhang, Institute of Intelligent Imaging Phenomics, International Human Phenome Institutes (Shanghai), Shanghai 200040, China
Author contributions: All authors contributed to this paper; Geng DY and Zhang J designed the outline for the review; Lv K wrote the review; Cao X, Du P, and Fu JY offered assistance for correct the syntax errors of the paper; Zhang J and Lv K revised and edited the final version.
Supported by the Shanghai Municipal Commission of Science and Technology, No. 19411951200; Clinical Research Plan of SHDC, No. SHDC2020CR3020A; and the Research Startup Fund of Huashan Hospital Fudan University, No. 2021QD035.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Dao-Ying Geng, MD, PhD, Dean, Doctor, Department of Radiology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai 200040, China.
Received: November 16, 2021
Peer-review started: November 16, 2021
First decision: December 26, 2021
Revised: January 9, 2022
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: May 28, 2022

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, accounting for about 90% of liver cancer cases. It is currently the fifth most common cancer in the world and the third leading cause of cancer-related mortality. Moreover, recurrence of HCC is common. Microvascular invasion (MVI) is a major factor associated with recurrence in postoperative HCC. It is difficult to evaluate MVI using traditional imaging modalities. Currently, MVI is assessed primarily through pathological and immunohistochemical analyses of postoperative tissue samples. Needle biopsy is the primary method used to confirm MVI diagnosis before surgery. As the puncture specimens represent just a small part of the tumor, and given the heterogeneity of HCC, biopsy samples may yield false-negative results. Radiomics, an emerging, powerful, and non-invasive tool based on various imaging modalities, such as computed tomography, magnetic resonance imaging, ultrasound, and positron emission tomography, can predict the HCC-MVI status preoperatively by delineating the tumor and/or the regions at a certain distance from the surface of the tumor to extract the image features. Although positive results have been reported for radiomics, its drawbacks have limited its clinical translation. This article reviews the application of radiomics, based on various imaging modalities, in preoperative evaluation of HCC-MVI and explores future research directions that facilitate its clinical translation.

Keywords: Microvascular invasion, Hepatocellular carcinoma, Radiomics, Texture analysis, Diagnostic imaging, Liver

Core Tip: Hepatocellular carcinoma-microvascular invasion (HCC-MVI) is closely related to the prognosis of patients, so accurate and individualized prediction of MVI status before treatment is very important. Radiomics is a non-invasive method for predicting HCC-MVI status preoperatively. The standardization of relevant implementation processes of radiomics, such as the delineation of the region of interest, the improvement of algorithms, and the combination of liver imaging reporting and data system, will all contribute to the accurate prediction of MVI. In addition, the introduction of the biological significance of the disease can make up for the shortcomings of the clinical transformation of radiomics to a certain extent.