Predicting early recurrence in hepatocellular carcinoma after hepatectomy using GD-EOB-DTPA enhanced MRI-based model.

Purpose: To develop and validate a comprehensive model for predicting postoperative early recurrence of hepatocellular carcinoma (HCC) based on gadoxetate disodium (Gd-EOB-DTPA)-enhanced MRI.

Methods: 239 patients with HCC who underwent curative surgical resection were recruited from two centers between April 2017 and December 2022. Radiomics features were extracted from the region of interest (ROI) on preoperative Gd-EOB-DTPA-enhanced MR images, and consistency analysis was performed to select stable radiomics features. Significant variables in the univariate and multivariate logistic regression analysis were included in clinical-radiologic model. Nomograms were constructed by combining the best performing radiologic and clinical-radiologic characteristics. Recurrence-free survival (RFS) comparisons were conducted using the log-rank test based on high versus low model-derived scores.

Results: The radiomics model based on multiple phases MR outperformed all other radiomics models and had the best discrimination for early recurrence, with AUC of 0.799 and 0.743 in the training and validation sets, respectively. In the entire cohort, high-risk patients exhibited significantly lower RFS compared to low-risk patients.

Conclusion: The nomogram integrating Gd-EOB-DTPA enhanced MRI radiomics features and clinical-radiologic characteristics demonstrate superior predictive performance with postoperative early recurrence in patients with HCC. The model can identify patients at high risk and provide support for individualized treatment planning.