Diagnostic value of whole-tumor apparent diffusion coefficient map radiomics analysis in predicting early recurrence of solitary hepatocellular carcinoma ≤ 5 cm

Purpose To evaluate the role of whole-tumor radiomics analysis of apparent diffusion coefficient (ADC) maps in predicting early recurrence (ER) of solitary hepatocellular carcinoma (HCC) <= 5 cm and compare the diagnostic efficiency of whole-tumor and single-slice ADC measurements. Methods One hundred and seventy patients with primary HCC were randomly divided into the training set (n = 119) and the test set (n = 51). The diagnostic efficiency was compared between the whole-tumor and single-slice ADC measurements. The clinical-radiological model was established by selected significant clinical characteristics and qualitative imaging features. The radiomics model was constructed using the least absolute shrinkage and selection operator (LASSO) logistic regression algorithm. The significant clinical-radiological risk factors and radiomics features were integrated to develop the combined model. Receiver operating characteristic (ROC) curves were used for evaluating the predictive performance. Results Cirrhosis, age, and albumin were significantly associated with ER in the clinical-radiological model selected by the random forest classifier. The diagnostic efficiency of the whole-tumor ADC measurements was slight higher than that of the single-slice (AUC = 0.602 and 0.586, respectively). The clinical-radiological model (AUC = 0.84 and 0.82 in the training and test sets, respectively) showed better diagnostic performance than the radiomics model (AUC = 0.70 and 0.69 in the training and test sets, respectively) in predicting ER. The combined model showed optimal predictive performance with the highest AUC values of 0.88 and 0.85 in the training and test sets, respectively. Conclusions The whole-tumor ADC measurements performed better than the single-slice ADC measurements. The clinical-radiological model performed better than the radiomics model for predicting ER in patients with solitary HCC <= 5 cm.