Keywords: Liver, Treatment Response, pathological complete response, transarterial therapy, mRECIST
Motivation: Identifying pathological complete response (pCR) nodules in hepatocellular carcinoma (HCC) after transarterial therapy is crucial to avoid unnecessary hepatectomy and retain liver function.
Goal(s): To improve the performance in pCR diagnosis beyond current mRECIST method, which has limited precision.
Approach: This study integrated complete perilesional ring features (complete hyper- and hypo-rings) on MR with mRECIST to stratify nodules into hyper-ring, hypo-ring, and no-ring categories.
Results: The ring classification refined pCR prediction, increasing the precision from 75.0% to 85.4% for hyper-ring nodules, while obtaining a lower pCR probability of 56.1% for the no-ring group, allowing more personalized treatment strategies.
Impact: The ring classification provides a more specific pCR probability on the basis of mRECIST, guiding 46.1% nodules with 85.4% pCR possibility to Watch & Wait strategy, and 27.4% nodules with 56.1% pCR possibility to comprehensive treatment by liver surgeon.
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