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Hepatocellular carcinoma (HCC), – the main form of liver cancer –, is the second global leading cause of cancer-related mortality. LI-RADS is considered the worldwide non-invasive standard method for imaging interpretation and reporting in patients with HCC eliminating the need for biopsy. However, it might be prone to interpretation subjectivity. Therefore, we develop an objective non-invasive AI-based grading system for HCC for appropriate etiology treatment plans. The developed system integrates potential image-based markers that represent the tumor’s morphology, functionality, and appearance/texture with the associated clinical biomarkers. The study encompasses 117 patients diagnosed with HCC and was divided into three different groups (group 1: benign low-grade (LR 1,2), N = 41; group 2: malignant high-grade (LR 4,5), N = 39; and group 3: malignant not HCC (LR-M), N = 37). Diffusion-weighted magnetic resonance imaging (DWI) was acquired for imaging-based markers identification. The developed grading system pipeline includes: i) estimation of morphological markers using a new parametric spherical harmonic model, ii) estimation of appearance/textural markers using a novel rotation invariant circular binary pattern model, iii) calculation of the functional markers by constructing the representative cumulative distribution functions of the estimated apparent diffusion coefficients, and iv) integrating the aforementioned imaging-based markers with the associated clinical biomarkers, known as Alpha-fetoprotein. The integrated markers were optimized to train and test multiple machine learning (ML) classifiers and a hyper-tuned custom CNN. On a randomly stratified train (80%) test (20%) split scheme, the developed obtained an overall accuracy of 88% in differentiating between the three groups using the integrated markers along with the CatBoost classifier, surpassing the diagnostic performance of individual marker sets, other ML classifiers, and the CNN as well. The obtained results demonstrate the feasibility of the developed system as a novel tool for non-invasive and objective HCC grading.

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A New AI System for Precise Grading of HCC Based on Analyzing DW-MRI Radiomics and Alpha-fetoprotein as Liver Cancer Clinical Marker

  • 会议论文

  • 发表日期：

    2025年

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  • Abdelrhman Elkhouly,
  • Ahmed Alksas,
  • Gehad A. Saleh,
  • Mohamed Shehata,
  • Abdelrahman Karawia,
  • Mohammed Ghazal,
  • Sohail Contractor,
  • Ayman El-Baz

摘要

Hepatocellular carcinoma (HCC), – the main form of liver cancer –, is the second global leading cause of cancer-related mortality. LI-RADS is considered the worldwide non-invasive standard method for imaging interpretation and reporting in patients with HCC eliminating the need for biopsy. However, it might be prone to interpretation subjectivity. Therefore, we develop an objective non-invasive AI-based grading system for HCC for appropriate etiology treatment plans. The developed system integrates potential image-based markers that represent the tumor’s morphology, functionality, and appearance/texture with the associated clinical biomarkers. The study encompasses 117 patients diagnosed with HCC and was divided into three different groups (group 1: benign low-grade (LR 1,2), N = 41; group 2: malignant high-grade (LR 4,5), N = 39; and group 3: malignant not HCC (LR-M), N = 37). Diffusion-weighted magnetic resonance imaging (DWI) was acquired for imaging-based markers identification. The developed grading system pipeline includes: i) estimation of morphological markers using a new parametric spherical harmonic model, ii) estimation of appearance/textural markers using a novel rotation invariant circular binary pattern model, iii) calculation of the functional markers by constructing the representative cumulative distribution functions of the estimated apparent diffusion coefficients, and iv) integrating the aforementioned imaging-based markers with the associated clinical biomarkers, known as Alpha-fetoprotein. The integrated markers were optimized to train and test multiple machine learning (ML) classifiers and a hyper-tuned custom CNN. On a randomly stratified train (80%) test (20%) split scheme, the developed obtained an overall accuracy of 88% in differentiating between the three groups using the integrated markers along with the CatBoost classifier, surpassing the diagnostic performance of individual marker sets, other ML classifiers, and the CNN as well. The obtained results demonstrate the feasibility of the developed system as a novel tool for non-invasive and objective HCC grading.