MR radiomics to predict microvascular invasion status and biological processes in combined hepatocellular carcinoma-cholangiocarcinoma

Motivation: Prognostic value of microvascular invasion (MVI) in combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) was verified, and an effective prediction model is warranted to facilitate risk stratification and individual management. Goal(s): To establish an MRI-based radiomics model for predicting MVI status of cHCC-CCA, and to investigate biological processes underlying the radiomics model. Approach: Clinical data, conventional MR features, MR-based radiomics features and RNA sequencing data were collected and analyzed. Results: A robust MRI-based radiomics model was established for predicting MVI status in cHCC-CCA, in which potential prognostic value and underlying biological processes that regulate immune response were demonstrated. Impact: MVI is a significant manifestation of tumor invasiveness,and the MR-based radiomics model established in our study will facilitate risk stratification. Furthermore, underlying biological processes demonstrated in radiomics model will offer valuable insights for guiding immunotherapy strategies.