PET-guided attention for prediction of microvascular invasion in preoperative hepatocellular carcinoma on PET/CT.

Purpose: To achieve PET/CT-based preoperative prediction of microvascular invasion in hepatocellular carcinoma by combining the advantages of PET and CT.

Methods: This retrospective study included a total of 100 patients from two institutions who underwent PET/CT imaging. The above patients were divided into a training cohort (n = 70) and a validation cohort (n = 30). This study was based on PET/CT images to evaluate the possibility of microvascular invasion (MVI) of patients. In this study, we proposed a two-branch PET-guided attention network to predict MVI. The model used a two-branch network to extract image features from PET and CT, respectively. The PET-guided attention module aimed to enable the model to focus on the lesion region and reduce the disturbance of irrelevant and redundant information. Model performance was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.

Results: The method outperformed the single-modality prediction model for preoperative hepatocyte microvascular invasion, achieving an AUC of 0.907. On the validation set, accuracy reached 0.846, precision reached 0.881, recall 0.793, and F1-score 0.835.

Conclusion: The model exploits the particularities of the molecular metabolic function of PET and the anatomical structure of CT and can strongly improve the accuracy of clinical diagnosis of MVI.