• Minghui Wu, Hongna Tan, Fei Gao, Jinjin Hai, Peigang Ning, Jian Chen, Shaocheng Zhu, Meiyun Wang, Shewei Dou, and Dapeng Shi.
• Radiological Department of the People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, Henan, China.
• Eur Radiol. 2019 Jun 1; 29 (6): 2802-2811.

PurposeThis study was conducted in order to investigate the value of magnetic resonance imaging (MRI)-based radiomics signatures for the preoperative prediction of hepatocellular carcinoma (HCC) grade.MethodsData from 170 patients confirmed to have HCC by surgical pathology were divided into a training group (n = 125) and a test group (n = 45). The radiomics features of tumours based on both T1-weighted imaging (WI) and T2WI were extracted by using Matrix Laboratory (MATLAB), and radiomics signatures were generated using the least absolute shrinkage and selection operator (LASSO) logistic regression model. The predicted values of pathological HCC grades using radiomics signatures, clinical factors (including age, sex, tumour size, alpha fetoprotein (AFP) level, history of hepatitis B, hepatocirrhosis, portal vein tumour thrombosis, portal hypertension and pseudocapsule) and the combined models were assessed.ResultsRadiomics signatures could successfully categorise high-grade and low-grade HCC cases (p < 0.05) in both the training and test datasets. Regarding the performances of clinical factors, radiomics signatures and the combined clinical and radiomics signature (from the combined T1WI and T2WI images) models for HCC grading prediction, the areas under the curve (AUCs) were 0.600, 0.742 and 0.800 in the test datasets, respectively. Both the AFP level and radiomics signature were independent predictors of HCC grade (p < 0.05).ConclusionsRadiomics signatures may be important for discriminating high-grade and low-grade HCC cases. The combination of the radiomics signatures with clinical factors may be helpful for the preoperative prediction of HCC grade.Key Points• The radiomics signature based on non-contrast-enhanced MR images was significantly associated with the pathological grade of HCC. • The radiomics signatures based on T1WI or T2WI images performed similarly at predicting the pathological grade of HCC. • Combining the radiomics signature and clinical factors (including age, sex, tumour size, AFP level, history of hepatitis B, hepatocirrhosis, portal vein tumour thrombosis, portal hypertension and pseudocapsule) may be helpful for the preoperative prediction of HCC grade.

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