Nomogram prediction of vessels encapsulating tumor clusters in small hepatocellular carcinoma ≤ 3 cm based on enhanced magnetic resonance imaging

Figure 1 Flowchart of patient selection. HCC: Hepatocellular carcinoma; VETC: Vessels encapsulating tumor clusters.

Figure 2 Nomogram for preoperative evaluation of vessels encapsulating tumor clusters status in small hepatocellular carcinoma. A vertical line is drawn to obtain alpha-fetoprotein_lg10, carbohydrate antigen 199, shape, margin, and arterial peritumoral enhancement scores. The total score of the five factors is displayed on the total score axis, and a vertical line is drawn downwards to represent the probability of vessels encapsulating tumor clusters positivity. CA199: Carbohydrate antigen 199; AFP: Alpha-fetoprotein; VETC: Vessels encapsulating tumor clusters.

Figure 3 Receiver operating characteristic curves for training set, test set, and validation set. ROC: Receiver operating characteristic; AUC: Area under the curve.

Figure 4 Calibration curves and decision curves for training, test, and validation sets. A: Calibration curves; B: Decision curves.

Figure 5 Representative images of qualitative gadopentetate dimeglumine-enhanced magnetic resonance imaging features for early recurrence in small hepatocellular carcinoma patients with actual and predicted vessels encapsulating tumor clusters positivity. A: In a 49-year-old man with a tumor size of 1.9 cm, T2-weighted imaging showed that the tumor had irregular shape and non-smooth margin; B: Intratumoral non-rim homogeneous hyperenhancement in the arterial phase; C: In the portal phase, there was an enhanced signal with a volcanic shape observed around the tumor; D: The enhancement within the tumor exhibited rapid washout and relatively low signals in the delayed phase.

Figure 6 Kaplan-Meier analysis for association of early recurrence with actual and predicted vessels encapsulating tumor clusters status. A: Actual vessels encapsulating tumor clusters (VETC) status; B: Predicted VETC status. VETC: Vessels encapsulating tumor clusters.