Abstract
OBJECTIVE: To construct and validate the optimal model for preoperative prediction of proliferative HCC based on habitat-derived radiomics features of Gd-EOB-DTPA-Enhanced MRI. METHODS: A total of 187 patients who underwent Gd-EOB-DTPA-enhanced MRI before curative partial hepatectomy were divided into training (n=130, 50 proliferative and 80 nonproliferative HCC) and validation cohort (n=57, 25 proliferative and 32 nonproliferative HCC). Habitat subregion generation was performed using the Gaussian Mixture Model (GMM) clustering method to cluster all pixels to identify similar subregions within the tumor. Radiomic features were extracted from each tumor subregion in the arterial phase (AP) and hepatobiliary phase (HBP). Independent sample t tests, Pearson correlation coefficient, and Least Absolute Shrinkage and Selection Operator (LASSO) algorithm were performed to select the optimal features of subregions. After feature integration and selection, machine-learning classification models using the sci-kit-learn library were constructed. Receiver Operating Characteristic (ROC) curves and the DeLong test were performed to compare the identified performance for predicting proliferative HCC among these models. RESULTS: The optimal number of clusters was determined to be 3 based on the Silhouette coefficient. 20, 12, and 23 features were retained from the AP, HBP, and the combined AP and HBP habitat (subregions 1, 2, 3) radiomics features. Three models were constructed with these selected features in AP, HBP, and the combined AP and HBP habitat radiomics features. The ROC analysis and DeLong test show that the Naive Bayes model of AP and HBP habitat radiomics (AP-HBP-Hab-Rad) archived the best performance. Finally, the combined model using the Light Gradient Boosting Machine (LightGBM) algorithm, incorporating the AP-HBP-Hab-Rad, age, and AFP (Alpha-Fetoprotein), was identified as the optimal model for predicting proliferative HCC. For the training and validation cohort, the accuracy, sensitivity, specificity, and AUC were 0.923, 0.880, 0.950, 0.966 (95% CI: 0.937-0.994) and 0.825, 0.680, 0.937, 0.877 (95% CI: 0.786-0.969), respectively. In its validation cohort of the combined model, the AUC value was statistically higher than the other models ( P <0.01). CONCLUSIONS: A combined model, including AP-HBP-Hab-Rad, serum AFP, and age using the LightGBM algorithm, can satisfactorily predict proliferative HCC preoperatively.