Academic Journal
A Clinical-Radiomics Nomogram Predicts Early Tumor Necrosis After Transarterial Chemoembolization for Hepatocellular Carcinoma.
| Title: | A Clinical-Radiomics Nomogram Predicts Early Tumor Necrosis After Transarterial Chemoembolization for Hepatocellular Carcinoma. |
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| Authors: | Wu XL; School of Basic Medical Sciences, Guangxi Medical University, Nanning, Guangxi, China.; Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control (Guangxi Zhuang Autonomous Region Academy of Preventive Medicine), Nanning, Guangxi, China., Duan BZ; Department of Otolaryngology-Head and Neck Surgery, Tongren Second People's Hospital, Tongren, Guizhou, China., Jiang ZH; Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control (Guangxi Zhuang Autonomous Region Academy of Preventive Medicine), Nanning, Guangxi, China., Zeng SS; Department of Radiology, The Second People's Hospital of China Three Gorges University, Yichang, Hubei, China., Lin GC; Department of Radiology, The Second People's Hospital of China Three Gorges University, Yichang, Hubei, China., Fang ZL; School of Basic Medical Sciences, Guangxi Medical University, Nanning, Guangxi, China.; Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control (Guangxi Zhuang Autonomous Region Academy of Preventive Medicine), Nanning, Guangxi, China. |
| Source: | Technology in cancer research & treatment [Technol Cancer Res Treat] 2026 Jan-Dec; Vol. 25, pp. 15330338261444986. Date of Electronic Publication: 2026 Apr 18. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: SAGE Country of Publication: United States NLM ID: 101140941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1533-0338 (Electronic) Linking ISSN: 15330338 NLM ISO Abbreviation: Technol Cancer Res Treat Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2015-: Thousand Oaks, CA : SAGE Original Publication: Schenectady, NY : Adenine Press, c2002- |
| MeSH Terms: | Liver Neoplasms*/therapy , Liver Neoplasms*/pathology , Liver Neoplasms*/diagnostic imaging , Liver Neoplasms*/diagnosis , Carcinoma, Hepatocellular*/therapy , Carcinoma, Hepatocellular*/pathology , Carcinoma, Hepatocellular*/diagnostic imaging , Carcinoma, Hepatocellular*/diagnosis , Chemoembolization, Therapeutic*/methods , Chemoembolization, Therapeutic*/adverse effects , Nomograms*, Humans ; Radiomics ; Female ; Necrosis ; Male ; Middle Aged ; Aged ; Treatment Outcome ; Prognosis ; ROC Curve ; Tomography, X-Ray Computed |
| Abstract: | IntroductionWe introduce a standardized necrosis rate-percent reduction in enhancing tumor diameter normalized by baseline tumor diameter-with a threshold of ≥30%. This endpoint is derived from the mRECIST partial response criteria but is normalized to mitigate tumor size-dependent bias. A clinical-radiomics model was developed to assess necrosis in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE).MethodsRetrospectively, 95 HCC patients undergoing TACE were included. Radiomics features were selected via LASSO regression, and clinical variables via logistic regression. Separate radiomics and clinical models were developed, and a combined model was constructed using multivariable logistic regression. The cohort was randomly split into training (70%) and validation (30%) sets, with all preprocessing, feature selection, and model training confined to the training set to prevent data leakage. Model performance was evaluated using discrimination (AUC), calibration, clinical utility (decision curve analysis), and a nomogram.ResultsFrom 1,316 extracted radiomics features, six were retained for Rad-score calculation. Key clinical predictors included hepatitis group, standardized viable tumor ratio, and vascular invasion. The integrated model achieved AUCs of 0.865 (95% CI: 0.768-0.961) in training and 0.853 (95% CI: 0.716-0.990) in validation (n=29), outperforming the clinical model (AUCs: 0.808 (95% CI: 0.695-0.922) and 0.666 (95% CI: 0.465-0.866), respectively). Decision curve analysis and calibration plots confirmed the combined model's superior performance.ConclusionThe radiomics-clinical nomogram, based on a standardized necrosis rate, may enable early prediction of TACE response, offering potential insights for therapeutic decision-making, risk stratification, and liver transplantation management. External validation is warranted before clinical application. |
| Competing Interests: | Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with the research, authorship, and publication of this article. |
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| Contributed Indexing: | Keywords: hepatocellular carcinoma (HCC); necrosis; predictive model; radiomics; transarterial chemoembolization (TACE) |
| Entry Date(s): | Date Created: 20260418 Date Completed: 20260715 Latest Revision: 20260813 |
| Update Code: | 20260910 |
| PubMed Central ID: | PMC13100383 |
| DOI: | 10.1177/15330338261444986 |
| PMID: | 41999190 |
| Database: | MEDLINE |
| ISSN: | 1533-0338 |
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| DOI: | 10.1177/15330338261444986 |