Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2024; 30(4): 381-417
Published online Jan 28, 2024. doi: 10.3748/wjg.v30.i4.381
Current status of magnetic resonance imaging radiomics in hepatocellular carcinoma: A quantitative review with Radiomics Quality Score
Valentina Brancato, Marco Cerrone, Nunzia Garbino, Marco Salvatore, Carlo Cavaliere
Valentina Brancato, Department of Information Technology, IRCCS SYNLAB SDN, Naples 80143, Italy
Marco Cerrone, Nunzia Garbino, Marco Salvatore, Carlo Cavaliere, Department of Radiology, IRCCS SYNLAB SDN, Naples 80143, Italy
Author contributions: Brancato V, Cerrone M and Cavaliere C conceptualized the problem determined the review scope and strategies; Cerrone M, Garbino N, and Cavaliere C conducted the searching and screening of the literature and reviewed the selected articles; Brancato V performed statistical analyses and drafted statistical sections; Cerrone M and Brancato V wrote the manuscript; Brancato V, Cerrone M, Salvatore M and Cavaliere C reviewed and edited the manuscript draft; all authors contributed to the article and approved the submitted version.
Supported by the “Ricerca Corrente” Grant from Italian Ministry of Health, No. IRCCS SYNLAB SDN.
Conflict-of-interest statement: Authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Cerrone, BSc, Researcher, Department of Radiology, IRCCS SYNLAB SDN, Via E. Gianturco 113, Naples 80143, Italy. marco.cerrone@synlab.it
Received: October 31, 2023
Peer-review started: October 31, 2023
First decision: November 24, 2023
Revised: December 5, 2023
Accepted: January 10, 2024
Article in press: January 10, 2024
Published online: January 28, 2024
Processing time: 86 Days and 21.4 Hours
ARTICLE HIGHLIGHTS
Research background

Radiomics is a promising tool that may increase the value of Magnetic Resonance Imaging (MRI) for different tasks linked to the management of patients with hepatocellular carcinoma (HCC).

Research motivation

Over the last decade, there has been a substantial increase in radiomics studies in the field of HCC. Many of these studies have demonstrated the power of radiomic features for differential diagnosis, grading, predicting microvascular invasion, overall survival, recurrence, and treatment response. However, the use of radiomics in HCC is currently limited to academic literature, and no studies have yet been translated into clinical applications. This has led to doubts among clinicians about the radiomics validity. This is in part due to many issues related to the methodological quality of radiomic studies.

Research objectives

To summarize the status of MRI radiomic studies concerning HCC, using the radiomics quality score (RQS) to assess the quality of the methodology used in each study.

Research methods

We systematically reviewed PubMed, Google Scholar, and Web of Science databases to identify original articles focused on using MRI radiomics for HCC management published between 2017 and 2023. The RQS tool was employed to evaluate the methodological quality of radiomic studies. Spearman’s correlation (ρ) analysis was conducted to investigate the association between RQS and journal metrics, as well as the characteristics of the studies. The threshold for statistical significance was established at P < 0.05.

Research results

127 articles were included, of which 43 focused on HCC prognosis, 39 on prediction of pathological findings, 16 on prediction of the expression of molecular markers outcomes, 18 had a diagnostic purpose, and 11 had multiple aims. Mean RQS was 8 ± 6.22, with the corresponding percentage of 24.15% ± 15.25% (ranging from 0.0 to 58.33%). RQS was positively correlated with journal impact factor (IF; ρ = 0.36, P =2.98 × 10-5), 5-years IF (ρ = 0.33, P = 1.56 × 10-4), number of patients involved (ρ = 0.51, P < 9.37 × 10-10) and number of radiomics features (ρ = 0.59, P < 4.59 × 10-13) extracted in the study, and time of publication (ρ = -0.23, P = 0.0072).

Research conclusions

Although the MRI radiomics in HCC represents an auspicious tool for developing adequate personalized treatment as a noninvasive approach in HCC patients, our study revealed that studies in this field still lack the quality required to allow its introduction in clinical practice.

Research perspectives

Although recent advantages in MRI radiomics can potentially satisfy the urgent need for noninvasive, radiation-free and quantitative strategies that can aid in HCC treatment decision making, studies in this field still lack the quality required to allow its introduction in clinical practice. Future studies including external validation and adhering to the standardization of radiomics features are necessary. Moreover, limitations and challenges related to feature reproducibility, analysis of the clinical utility, and openness of science need to be addressed. This work may provide new insights and contribute to a common understanding of the use of radiomics in the assessment of HCC.