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Background <p>Transarterial chemoembolization (TACE) is the standard treatment for patients with intermediate-stage hepatocellular carcinoma (HCC), but the rate of complete response (CR) after TACE varies widely. Pretreatment identification of patients likely to achieve CR remains clinically challenging.</p> Purpose <p>To assess the pretreatment predictive value of liver imaging reporting and data system (LI-RADS) features and clinical features on gadoxetic acid-enhanced MRI (EOB-MRI) for CR after TACE in patients with HCC &gt; 2&#xa0;cm.</p> Methods <p>From June 2018 to June 2025, 167 patients with unresectable HCC were enrolled in this retrospective single-center study. All patients underwent EOB-MRI within 2 weeks before initial TACE. Treatment response was classified as CR or non-complete response (nCR) using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Clinical and MRI features associated with CR were identified using univariate and multivariate logistic regression analyses. The area under the receiver operating characteristic curve (AUC) was used to assess the model performance.</p> Results <p>A total of 61 of the 167 patients (36.5%) achieved CR on follow-up imaging at 3–4 months after TACE. Multivariate analysis revealed that tumor diameter (odds ratio [OR]: 0.965, 95% confidence interval [CI]: 0.943–0.987; <i>p</i> = 0.002), irregular border (OR: 0.404, 95% CI: 0.196–0.832; <i>p</i> = 0.014), and enhancing capsule (OR: 3.006, 95% CI: 1.147–7.877; <i>p</i> = 0.025) were significantly associated with CR. The combined model incorporating these three features yielded an AUC of 0.723 (95% CI: 0.649–0.790, <i>p</i> &lt; 0.0001), outperforming that of each individual predictor (AUC = 0.658, 0.615, and 0.565, respectively).</p> Conclusions <p>A simple imaging-based model incorporating tumor diameter, irregular border, and enhancing capsule achieved moderate performance for predicting CR after TACE in patients with HCC &gt; 2&#xa0;cm, and may serve as a practical tool for response stratification and individualized treatment decisions.</p>

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Clinical and LI-RADS features on gadoxetic acid‑enhanced MRI for predicting complete response after transarterial chemoembolization in hepatocellular carcinoma > 2 cm

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Chuhang Liu,
  • Shuya Tan,
  • Xinpei Hu,
  • Yaoning Chen,
  • Cen Hu,
  • Hanqi Liu,
  • Tong Zhao,
  • Yujia Chen,
  • Yangyang Liu

摘要

Background

Transarterial chemoembolization (TACE) is the standard treatment for patients with intermediate-stage hepatocellular carcinoma (HCC), but the rate of complete response (CR) after TACE varies widely. Pretreatment identification of patients likely to achieve CR remains clinically challenging.

Purpose

To assess the pretreatment predictive value of liver imaging reporting and data system (LI-RADS) features and clinical features on gadoxetic acid-enhanced MRI (EOB-MRI) for CR after TACE in patients with HCC > 2 cm.

Methods

From June 2018 to June 2025, 167 patients with unresectable HCC were enrolled in this retrospective single-center study. All patients underwent EOB-MRI within 2 weeks before initial TACE. Treatment response was classified as CR or non-complete response (nCR) using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Clinical and MRI features associated with CR were identified using univariate and multivariate logistic regression analyses. The area under the receiver operating characteristic curve (AUC) was used to assess the model performance.

Results

A total of 61 of the 167 patients (36.5%) achieved CR on follow-up imaging at 3–4 months after TACE. Multivariate analysis revealed that tumor diameter (odds ratio [OR]: 0.965, 95% confidence interval [CI]: 0.943–0.987; p = 0.002), irregular border (OR: 0.404, 95% CI: 0.196–0.832; p = 0.014), and enhancing capsule (OR: 3.006, 95% CI: 1.147–7.877; p = 0.025) were significantly associated with CR. The combined model incorporating these three features yielded an AUC of 0.723 (95% CI: 0.649–0.790, p < 0.0001), outperforming that of each individual predictor (AUC = 0.658, 0.615, and 0.565, respectively).

Conclusions

A simple imaging-based model incorporating tumor diameter, irregular border, and enhancing capsule achieved moderate performance for predicting CR after TACE in patients with HCC > 2 cm, and may serve as a practical tool for response stratification and individualized treatment decisions.