Correlation study of 18F-FDG PET/CT metabolic parameters, heterogeneity index, and microvascular invasion, and its nomogram potential in predicting microvascular invasion in liver cancer before liver transplantation

The integration of PET/CT-derived parameters-specifically TLG (metabolic burden), HI (heterogeneity), and TLR (tumor-to-liver contrast)-with serum PIVKA-II provides a robust tool for preoperative MVI prediction in HCC patients undergoing liver transplantation. The validated nomogram model (AUC = 0.815) outperforms individual parameters, offering a reliable basis for clinical decision-making.