ViT-based quantification of intratumoral heterogeneity for predicting the early recurrence in HCC following multiple ablation
Ke Zhang
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorJinyu Ru
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
Search for more papers by this authorWenbo Wang
Department of Ultrasound, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
Search for more papers by this authorMin Xu
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorLei Mu
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorJinhua Pan
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorJionghui Gu
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorHaoyan Zhang
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
Search for more papers by this authorJie Tian
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Engineering Medicine, Beihang University, Beijing, China
Search for more papers by this authorCorresponding Author
Wei Yang
Department of Ultrasound, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
Correspondence
Wei Yang, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Email: [email protected]
Tianan Jiang, Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Email: [email protected]
Kun Wang, CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Tianan Jiang
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Correspondence
Wei Yang, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Email: [email protected]
Tianan Jiang, Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Email: [email protected]
Kun Wang, CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Kun Wang
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
Correspondence
Wei Yang, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Email: [email protected]
Tianan Jiang, Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Email: [email protected]
Kun Wang, CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Email: [email protected]
Search for more papers by this authorKe Zhang
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorJinyu Ru
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
Search for more papers by this authorWenbo Wang
Department of Ultrasound, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
Search for more papers by this authorMin Xu
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorLei Mu
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorJinhua Pan
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorJionghui Gu
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Search for more papers by this authorHaoyan Zhang
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
Search for more papers by this authorJie Tian
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Engineering Medicine, Beihang University, Beijing, China
Search for more papers by this authorCorresponding Author
Wei Yang
Department of Ultrasound, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
Correspondence
Wei Yang, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Email: [email protected]
Tianan Jiang, Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Email: [email protected]
Kun Wang, CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Tianan Jiang
Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Correspondence
Wei Yang, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Email: [email protected]
Tianan Jiang, Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Email: [email protected]
Kun Wang, CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Kun Wang
CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China
School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
Correspondence
Wei Yang, Department of Ultrasound, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Email: [email protected]
Tianan Jiang, Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Email: [email protected]
Kun Wang, CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.
Email: [email protected]
Search for more papers by this authorKe Zhang, Jinyu Ru, and Wenbo Wang contributed equally to this article.
Handling Editor: Dr. Alejandro Forner
Abstract
Objectives
This study aimed to develop a quantitative intratumoral heterogeneity (ITH) model for assessing the risk of early recurrence (ER) in pre-treatment multimodal imaging for hepatocellular carcinoma (HCC) patients undergoing ablation treatments.
Methods
This multi-centre study enrolled 633 HCC patients who underwent ultrasound-guided local ablation between January 2015 and September 2022. Among them, 422, 85, 57 and 69 patients underwent radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation (LA) and irreversible electroporation (IRE) ablation, respectively. Vision-Transformer-based quantitative ITH (ViT-Q-ITH) features were extracted from the US and MRI sequences. Multivariable logistic regression analysis was used to identify variables associated with ER. A combined model integrated clinic-radiologic and ViT-Q-ITH scores. The prediction performance was evaluated concerning calibration, clinical usefulness and discrimination.
Results
The final training cohort and internal validation cohort included 318 patients and 83 patients, respectively, who underwent RFA and MWA. The three external testing cohorts comprised of 106 patients treated with RFA, 57 patients treated with LA and 69 patients who underwent IRE ablation. The combined model showed excellent predictive performance for ER in the training (AUC: .99, 95% CI: .99–1.00), internal validation (AUC: .86, 95% CI: .78–.94), external testing (AUC: .83, 95% CI: .73–.92), LA (AUC: .84, 95% CI: .73–.95) and IRE (AUC: .82, 95% CI: .72–.93) cohorts, respectively. Decision curve analysis further affirmed the clinical utility of the combined model.
Conclusions
The multimodal-based model, incorporating clinic-radiologic factors and ITH features, demonstrated superior performance in predicting ER among early-stage HCC patients undergoing different ablation modalities.
CONFLICT OF INTEREST STATEMENT
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Open Research
DATA AVAILABILITY STATEMENT
Due to patient privacy considerations, data related to patients cannot be made publicly accessible. However, interested parties can request access to the data from the corresponding author through a reasonable inquiry process, subject to approval by the Institutional Review Board of all enrolled centres.
Supporting Information
| Filename | Description |
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| liv16051-sup-0001-Supinfo.docxWord 2007 document , 13.6 MB |
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| liv16051-sup-0002-Figure_S1.tifTIFF image, 12.7 MB |
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| liv16051-sup-0003-Figure_S2.tifTIFF image, 6.6 MB |
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| liv16051-sup-0004-Figure_S3.tifTIFF image, 7.9 MB |
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| liv16051-sup-0005-Figure_S4.tifTIFF image, 9.6 MB |
Figure S4. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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