A Radiomics Approach to Predict the Emergence of New Hepatocellular Carcinoma in Computed Tomography for High-Risk Patients with Liver Cirrhosis

• Main Authors: Eric Tietz, Daniel Truhn, Gustav Müller-Franzes, Marie-Luise Berres, Karim Hamesch, Sven Arke Lang, Christiane Katharina Kuhl, Philipp Bruners, Maximilian Schulze-Hagen
• Format: Article
• Language: English
• Published: MDPI AG 2021-09-01
• Series: Diagnostics
• Subjects: CT; liver cirrhosis; hepatocellular carcinoma; radiomics; tumor prediction
• Online Access: https://www.mdpi.com/2075-4418/11/9/1650

Liver cirrhosis poses a major risk for the development of hepatocellular carcinoma (HCC). This retrospective study investigated to what extent radiomic features allow the prediction of emerging HCC in patients with cirrhosis in contrast-enhanced computed tomography (CECT). A total of 51 patients with liver cirrhosis and newly detected HCC lesions (<i>n</i> = 82) during follow-up (FU-CT) after local tumor therapy were included. These lesions were not to have been detected by the radiologist in the chronologically prior CECT (PRE-CT). For training purposes, segmentations of 22 patients with liver cirrhosis but without HCC-recurrence were added. A total of 186 areas (82 HCCs and 104 cirrhotic liver areas without HCC) were analyzed. Using univariate analysis, four independent features were identified, and a multivariate logistic regression model was trained to classify the outlined regions as “HCC probable” or “HCC improbable”. In total, 60/82 (73%) of segmentations with later detected HCC and 84/104 (81%) segmentations without HCC were classified correctly (AUC of 81%, 95% CI 74–87%), yielding a sensitivity of 72% (95% CI 57–83%) and a specificity of 86% (95% CI 76–96%). In conclusion, the model predicted the occurrence of new HCCs within segmented areas with an acceptable sensitivity and specificity in cirrhotic liver tissue in CECT.