Predicting Microvascular Invasion and Early Recurrence in Hepatocellular Carcinoma Using DeepLab V3+ Segmentation of Multiregional MR Habitat Images.

Rationale And Objectives: Accurate identification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is crucial for treatment and prognosis. Single-modality and feature fusion models using manual segmentation fail to provide insights into MVI. This study aims to develop a DeepLab V3+ model for automated segmentation of HCC magnetic resonance (MR) images and a decision fusion model to predict MVI and early recurrence (ER).

Materials And Methods: This retrospective study included 209 HCC patients (146 in the training and 63 in the test cohorts). The performance of DeepLab V3+ for HCC MR image segmentation was evaluated using Dice Loss and F1 score. Intraclass correlation coefficients (ICCs) assessed feature extraction reliability. Spearman's correlation analyzed the relationship between tumor volumes from automated and manual segmentation, with agreement evaluated using Bland-Altman plots. Model performance was assessed using the area under the receiver operating characteristic curve (ROC AUC), calibration curves, and decision curve analysis. A nomogram predicted ER of HCC after surgery, with Kaplan-Meier analysis for 2-year recurrence-free survival (RFS).

Results: The DeepLab V3+ model demonstrated high segmentation accuracy, with strong agreement in feature extraction (ICC: 0.802-0.999). The decision fusion model achieved AUCs of 0.968 and 0.878 for MVI prediction, and the nomogram for predicting ER yielded AUCs of 0.782 and 0.690 in the training and test cohorts, respectively, with significant RFS differences between the risk groups.

Conclusion: The DeepLab V3+ model accurately segmented HCC. The decision fusion model significantly improved MVI prediction, and the nomogram offered valuable insights into recurrence risk for clinical decision-making.

Availability Of Data And Materials: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.