Published online Jul 14, 2023. doi: 10.3748/wjg.v29.i26.4186
Peer-review started: February 11, 2023
First decision: March 20, 2023
Revised: March 25, 2023
Accepted: June 6, 2023
Article in press: June 6, 2023
Published online: July 14, 2023
Hepatocellular carcinoma (HCC) seriously endangers human life and health, but there is still a lack of satisfactory treatment options. Even if it is diagnosed at early stage, the recurrence rate is still very high. The clinical monitoring strategy for HCC recurrence is limited, so there is a need to find a new and effective recurrence prediction model for HCC. And we developed a radiomics model based on preoperative contrast-enhanced computed tomography (CECT) to evaluate early recurrence in patients with a single tumour.
Due to the high malignancy and suppressive immune microenvironment of HCC, there are still high recurrence and metastasis rates even in HCC patients who have undergone radical resection. Therefore, it is of vital importance to conduct systematic surveillance of HCC recurrence, and there is an urgent need to precisely predict recurrence in patients with HCC. If tumour recurrence can be detected earlier, the survival and quality of life of HCC patients might be greatly improved.
Despite the rapid development in the treatment of HCC in recent decades, patients’ outcomes remain unsatisfactory. One of the reasons is that the early diagnosis system of HCC recurrence is not yet well developed, so our research team established a recurrence prediction model for HCC based on medical imaging such as computed tomography (CT) to predict HCC recurrence earlier, so that timely treatment measures can be taken.
We collected CT images from 537 clinical patients in two institutions and extracted valuable CT image features with 3D Slicer (v4.11, https://www.slicer.org). SPSS18.0 (SPSS Inc., Chicago, IL, United States) and R (version 4.0.3, https://www.rproject.org/) were used for statistical analyses and the prediction model of HCC recurrence was established jointly with AFP.
The radiomics scores calculated herein revealed significant differences between early and nonearly recurrence HCC patients. We combined radiomics and serum indicators to evaluate the risk of early recurrence, which was validated in an independent cohort. Our findings showed the value of predicting early recurrence in HCC patients by noninvasive indicators and might guide clinical decisions making. However, this is a retrospective analysis, and inherent biases are inevitable. We would conduct prospective trials with multimodality radiomics to confirm our results in future.
The preoperative radiomics model was shown to be effective for predicting early recurrence among patients with single HCC. Compared with pathological biopsy or other tests, this model is noninvasive and more convenient for HCC patients.
For HCC diagnosis, treatment, or prognosis assessment, more non-invasive methods are of great significance and needed.