Prediction of Hepatocellular Carcinoma Response to Transcatheter Arterial Chemoembolization: A Real-World Study Based on Non-Contrast Computed Tomography Radiomics and General Image Features

Abstract

Zheng Guo,1,2,* Nanying Zhong,3,* Xueming Xu,4 Yu Zhang,4 Xiaoning Luo,4 Huabin Zhu,3 Xiufang Zhang,3 Di Wu,5 Yingwei Qiu,6,7 Fuping Tu4 1Department of Oncology, Ganzhou Key Laboratory of Gastrointestinal Carcinomas, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China; 2Department of Hematology and Oncology, International Cancer Center, Shenzhen Key Laboratory of Precision Medicine for Hematological Malignancies, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center, Shenzhen, Guangdong, People’s Republic of China; 3First School of Clinical Medicine, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China; 4Department of Oncology, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China; 5Department of Imaging, First Affiliated Hospital of Gannan Medical University, Gannan Medical University, Ganzhou, Jiangxi, People’s Republic of China; 6Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China; 7Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yingwei Qiu; Fuping Tu Email [email protected]; [email protected]: To construct a predictive model of short-term response and overall survival for transcatheter arterial chemoembolization (TACE) treatment in hepatocellular carcinoma (HCC) patients based on non-contrast computed tomography (NC-CT) radiomics and clinical features.Methods: Ninety-four HCC patients who underwent CT scanning 1 week before the first TACE treatment were retrospectively recruited and divided randomly into a training group (n = 47) and a validation group (n = 47). NC-CT radiomics data were extracted using MaZda software, and the compound model was calculated from radiomics and clinical features by logistic regression. The performance of the different models was compared by examining the area under the receiver operating characteristic curve (AUC). The prediction of prognosis was evaluated using survival analysis.Results: Thirty NC-CT radiomic features were extracted and analyzed. The compound model was formed using four NC-CT run-length matrix (RLM) features and general image features, which included the maximum diameter (cm) of the tumor and the number of tumors (n). The AUCs of the model for TACE response were 0.840 and 0.815, whereas the AUCs of the six-and-twelve grade were 0.754 and 0.750 in the training and validation groups, respectively. HCC patients were divided into two groups using the cutoff value of the model: a group in which the TACE-response led to good survival and a group in which TACE-nonresponse caused poor prognosis.Conclusion: Radiomic features from NC-CT predicted TACE-response. The compound model generated by NC-CT radiomics and clinical features is effective and directly predicts TACE-response and overall survival. The model may be used repeatedly and is easy to operate.Keywords: hepatocellular carcinoma, transcatheter arterial chemoembolization, computed tomography, radiomics, texture

Keywords

• hepatocellular carcinoma
• transcatheter arterial chemoembolization
• computed tomography
• radiomics
• texture