Abstract
BACKGROUND: Deep learning-based super-resolution (SR) reconstruction can obtain high-quality images with more detailed information. AIM: To compare multiparametric normal-resolution (NR) and SR magnetic resonance imaging (MRI) in predicting the histopathologic grade in hepatocellular carcinoma. METHODS: We retrospectively analyzed a total of 826 patients from two medical centers (training 459; validation 196; test 171). T2-weighted imaging, diffusion-weighted imaging, and portal venous phases were collected. Tumor segmentations were conducted automatically by 3D U-Net. Based on generative adversarial network, we utilized 3D SR reconstruction to produce SR MRI. Radiomics models were developed and validated by XGBoost and Catboost. The predictive efficiency was demonstrated by calibration curves, decision curve analysis, area under the curve (AUC) and net reclassification index (NRI). RESULTS: We extracted 3045 radiomic features from both NR and SR MRI, retaining 29 and 28 features, respectively. For XGBoost models, SR MRI yielded higher AUC value than NR MRI in the validation and test cohorts (0.83 vs 0.79; 0.80 vs 0.78), respectively. Consistent trends were seen in CatBoost models: SR MRI achieved AUCs of 0.89 and 0.80 compared to NR MRI's 0.81 and 0.76. NRI indicated that the SR MRI models could improve the prediction accuracy by -1.6% to 20.9% compared to the NR MRI models. CONCLUSION: Deep learning-based SR MRI could improve the predictive performance of histopathologic grade in HCC. It may be a powerful tool for better stratification management for patients with operable HCC.