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

Table 1 Comparisons of clinicoradiological factors for predicting microvascular invasion status in training and validation datasets, n (%)

Variables	Training dataset (n = 189)				Validation dataset (n = 81)
	MVI absent	MVI present	P value	Effect size	MVI absent	MVI present	P value
Sex			0.778				0.291
Female	10 (14)	13 (11)			2 (6)	7 (15)
Male	63 (86)	103 (89)			32 (94)	40 (85)
Age (years)			0.297				0.21
≤ 50	15 (21)	33 (28)			8 (24)	5 (11)
> 50	58 (79)	83 (72)			26 (76)	42 (89)
Alcohol			1				0.979
No	62 (85)	99 (85)			28 (82)	40 (85)
Yes	11 (15)	17 (15)			6 (18)	7 (15)
Liver cirrhosis			0.695				1
No	12 (16)	23 (20)			7 (21)	10 (21)
Yes	61 (84)	93 (80)			27 (79)	37 (79)
Antiviral therapy			0.377				0.073
No	43 (59)	77 (66)			14 (41)	30 (64)
Yes	30 (41)	39 (34)			20 (59)	17 (36)
Ascites			0.689				0.269
No	42 (58)	62 (53)			13 (38)	25 (53)
Yes	31 (42)	54 (47)			21 (62)	22 (47)
Neutrophil (10 × 9/L)	2.56 (2.1, 3.78)	2.98 (2.47, 3.98)	0.038	0.820	2.96 (2.2, 3.48)	3.1 (2.35, 3.76)	0.629
Lymphocyte (10 × 9/L)	1.44 (1.22, 1.78)	1.29 (0.98, 1.74)	0.09		1.47 ± 0.58	1.56 ± 0.51	0.514
Platelets (10 × 9/L)	143 (116, 179)	154 (111, 196.5)	0.368		141.5 (124.75, 182.25)	169 (99.5, 204.5)	0.897
Monocyte (10 × 9/L)	0.39 (0.28, 0.53)	0.4 (0.33, 0.53)	0.341		0.42 (0.33, 0.52)	0.42 (0.36, 0.58)	0.789
NLR	1.65 (1.37, 2.6)	2.37 (1.6, 3.56)	0.002	0.735	2 (1.43, 2.89)	1.87 (1.48, 2.46)	0.838
PLR	98.8 (75.56, 135.94)	115.55 (84.56, 157.42)	0.07		102.76 (81.42, 134.8)	101.33 (69.76, 129.07)	0.348
LMR	3.56 (2.79, 4.67)	3.12 (2.2, 4.36)	0.027	1.191	3.43 ± 1.29	3.58 ± 1.36	0.612
Alanine aminotransferase (U/L)			0.505				0.125
≤ 40	49 (67)	71 (61)			24 (71)	24 (51)
> 40	24 (33)	45 (39)			10 (29)	23 (49)
Aspartate aminotransferase (U/L)			0.001	0.249			0.102
≤ 35	47 (64)	45 (39)			23 (68)	22 (47)
> 35	26 (36)	71 (61)			11 (32)	25 (53)
γ-Glutamyltransferase (U/L)			0.009	0.200			0.02
≤ 45	40 (55)	40 (34)			19 (56)	13 (28)
> 45	33 (45)	76 (66)			15 (44)	34 (72)
Total bilirubin (μmol/L)			0.039	0.164			0.508
≤ 23	66 (90)	90 (78)			31 (91)	40 (85)
> 23	7 (10)	26 (22)			3 (9)	7 (15)
Albumin (g/L)			0.115				1
≥ 40	44 (60)	55 (47)			23 (68)	31 (66)
< 40	29 (40)	61 (53)			11 (32)	16 (34)
Prealbumin (g/L)			0.291				0.234
≥ 180	51 (70)	71 (61)			28 (82)	32 (68)
< 180	22 (30)	45 (39)			6 (18)	15 (32)
Alkaline phosphatase (U/L)			0.116				0.108
≤ 135	62 (85)	86 (74)			32 (94)	38 (81)
> 135	11 (15)	30 (26)			2 (6)	9 (19)
Prothrombin time (second)			0.843				1
≤ 14	62 (85)	101 (87)			31 (91)	43 (91)
> 14	11 (15)	15 (13)			3 (9)	4 (9)
International normalized ratio	1.07 (0.99, 1.11)	1.04 (0.98, 1.09)	0.21		1.06 (1, 1.12)	1.03 (0.98, 1.1)	0.271
HBV DNA load (IU/mL)			0.972				1
< 10000	62 (85)	97 (84)			26 (76)	36 (77)
≥ 10000	11 (15)	19 (16)			8 (24)	11 (23)
α-fetoprotein (μg/L)			0.008	0.206			0.061
≤ 7	37 (51)	35 (30)			18 (53)	14 (30)
> 7	36 (49)	81 (70)			16 (47)	33 (70)
Tumor diameter (cm)	4 (3, 6)	6.25 (4, 9.5)	< 0.001	0.590	4 (3, 5.88)	6 (3, 9.1)	0.027
Tumor number			0.375				0.26
Solitary	70 (96)	107 (92)			34 (100)	44 (94)
Multiple	3 (4)	9 (8)			0 (0)	3 (6)
CNLC stage			< 0.001	0.294			0.034
Ⅰa	49 (67)	43 (37)			24 (71)	21 (45)
Ⅰb	22 (30)	65 (56)			10 (29)	23 (49)
Ⅱa	2 (3)	8 (7)			0 (0)	3 (6)
Child-Pugh			0.994				1
A	60 (82)	94 (81)			30 (88)	42 (89)
B	13 (18)	22 (19)			4 (12)	5 (11)
Lobe involved			< 0.001	0.308			0.002
Solitary	72 (99)	88 (76)			34 (100)	36 (77)
Multiple	1 (1)	28 (24)			0 (0)	11 (23)
Tumor margin			< 0.001	0.337			0.008
Smooth	42 (58)	28 (24)			21 (62)	14 (30)
Non-smooth	31 (42)	88 (76)			13 (38)	33 (70)
Tumor growth pattern			0.945				1
Intrahepatic growth	64 (88)	100 (86)			29 (85)	41 (87)
Extrahepatic growth	9 (12)	16 (14)			5 (15)	6 (13)
Enhancement pattern			1				0.177
Atypical	23 (32)	37 (32)			10 (29)	22 (47)
Typical	50 (68)	79 (68)			24 (71)	25 (53)
Peritumoral arterial enhancement			0.444				1
Absent	67 (92)	101 (87)			30 (88)	41 (87)
Present	6 (8)	15 (13)			4 (12)	6 (13)
Internal arteries			< 0.001	0.33			0.008
Absent	43 (59)	30 (26)			24 (71)	18 (38)
Present	30 (41)	86 (74)			10 (29)	29 (62)
Intratumor necrosis			< 0.001	0.275			0.033
Absent	38 (52)	29 (25)			19 (56)	14 (30)
Present	35 (48)	87 (75)			15 (44)	33 (70)
Enhancing capsule			0.236				0.158
Absent	40 (55)	52 (45)			17 (50)	15 (32)
Present	33 (45)	64 (55)			17 (50)	32 (68)
Peritumoral hypointensity ring			0.001	0.250			0.115
Absent	20 (27)	10 (9)			10 (29)	6 (13)
Present	53 (73)	106 (91)			24 (71)	41 (87)

Continuous variables were expressed as means ± SD or medians with interquartile ranges. Both antiviral therapy status and hepatitis B virus DNA load were collected from patients on admission. MVI: Microvascular invasion; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelets-to-lymphocyte ratio; LMR: Lymphocyte-to-monocyte ratio; CNLC stage: China liver cancer stage; HBV: Hepatitis B virus.

Table 2 Multivariate analyses of clinicoradiological factors and radiomics for predicting microvascular invasion status in the training dataset

Factors	Coefficient	P value	OR	95%CI
Tumor margin	0.976	0.012	2.655	1.241-5.679
Peritumoral hypointensity ring	1.679	0.002	5.360	1.857-15.477
Radscore (ROItumor-DP)	1.880	< 0.001	6.552	3.364-12.761
Intercept	-2.346	< 0.001	0.096

Radscore (ROI^tumor-DP): Radscore based on regions of interest of tumor from delayed phase contrast-enhanced computed tomography images: OR: Odds ratio.