Evaluating microvascular invasion in hepatitis B virus-related hepatocellular carcinoma based on contrast-enhanced computed tomography radiomics and clinicoradiological factors

Figure 1 Flow diagram of the study enrolment patients. HBsAg: Hepatitis B surface antigen; HBcAb: Anti-hepatitis B core antigen antibodies; HCC: Hepatocellular carcinoma; CECT: Contrast-enhanced computed tomography.

Figure 2 Workflow of radiomics analysis. ROI^tumor: Region of interest of tumor; ROI^peri: Region of interest of 5 mm-wide peritumoral area; ICC: Intra-class correlation coefficient; ROC: Receiver operating characteristic; AUC: Area under the curve.

Figure 3 Two cases to show representative clinicoradiological factors of microvascular invasion-negative and microvascular invasion-positive hepatocellular carcinoma. A: A 63-year-old man presented with a 4.0 cm solid mass in the right lobe of the liver, featuring a peritumoral hypointensity ring (orange arrow) and smooth tumor margin; B: A 46-year-old man presented with a 15 cm solid mass in the right lobe of the liver, featuring a non-smooth tumor margin and the absence of a peritumoral hypointensity ring (yellow arrow).

Figure 4 Calibration, discrimination, and clinical utility analysis of the radiologic-radiomics model for predicting microvascular invasion. A: Receiver operating characteristic analysis curve of the model; B-D: Calibration curves in the training (B) and validation (C) datasets, and decision curve (D) in the overall patients; E: The model is presented with a nomogram scaled by the proportional regression coefficient of each predictor. AFP: Alpha-fetoprotein; MVI: Microvascular invasion; radscore (ROI^tumor-DP): Represents the radscore based on regions of interest of tumor from delayed phase contrast-enhanced computed tomography images; ROC: Receiver operating characteristic; AUC: Area under the curve.

Figure 5 Calibration, discrimination, and clinical utility analysis of the model for predicting high-risk group. A: Receiver operating characteristic analysis curve of the model; B-D: Calibration curves in the training (B) and validation (C) datasets, and decision curve (D) in the overall patients; E: The model is presented with a nomogram scaled by the proportional regression coefficient of each predictor. AFP: Alpha-fetoprotein; AST: Aspartate aminotransferase; MVI: Microvascular invasion; radscore (ROI^peri-AP): Represents the radscore based on regions of interest of 5 mm-wide peritumoral area from arterial phase contrast-enhanced computed tomography images; M2: High-risk group; ROC: Receiver operating characteristic; AUC: Area under the curve.