Habitat imaging’s role in predicting HCC percentage in combined hepatocellular carcinoma-cholangiocarcinoma and its biologic underpinnings

Motivation: The prognostic value of component percentage in combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) was verified, but the identification of percentage of each component relies on extensive tumor sampling. Goal(s): Therefore, the aim of this study was to investigate if MRI-based habitat imaging helps to predict component percentage in cHCC-CCA preoperatively,Approach: and to further verify the biologic underpinnings of habitat imaging in cHCC-CCA by analyzing RNA sequencing data. Results: We found that preoperative prediction of HCC percentage in patients with cHCC-CCA can be achieved using an MRI-based habitat imaging model, which was also associated with signaling pathways regulating cell migration and tumor metastasis. Impact: We achieved prediction of HCC percentage through an MRI-based habitat imaging model, and revealed the biologic underpinnings of habitat imaging, that is, habitat imaging may identify patients at risk of metastasis. These results may guide individual management in cHCC-CCA patients.