MRI‐Based Radiomics Models Developed With Features of the Whole Liver and Right Liver Lobe: Assessment of Hepatic Inflammatory Activity in Chronic Hepatic Disease

Abstract

Background: The noninvasive assessment of hepatic inflammatory activity (HIA) is crucial for making clinical decisions and monitoring therapeutic efficacy in chronic liver disease (CLD). Purpose: To develop MRI-based radiomics models by extracting features from the whole liver and localized regions of the right liver lobe, compare the efficiency of two radiomics models, and further develop a radiomics nomogram for the assessment of HIA in CLD. Study Type: Retrospective. Population: In all, 137 consecutive patients. Field Strength/Sequence: 1.5T/T 2-weighted imaging. Assessment: All patients (nonsignificant HIA, n = 98; significant HIA, n = 39) were randomly divided into a training (n = 95) and a test cohort (n = 42). Radiomics features were extracted from the regions covering the whole liver (ROI-w) and localized regions of the right liver lobe (ROI-r). Least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analyses were used to select features and develop radiomics models. A combined model fusing the valuable radiomics features with clinical-radiological predictors was developed. Finally, a radiomics nomogram derived from the combined model was developed. Statistical Tests: Synthetic minority oversampling technique algorithm, LASSO, receiver operator characteristic curve, and calibration curve analysis were performed. Results: The area under the curve (AUC), sensitivity, and specificity of the ROI-w radiomics model in assessing HIA were 0.858, 0.800, and 0.733, respectively. The ROI-r model were 0.844, 0.733, and 0.867, respectively. No differences were detected between the two radiomics models (P = 0.8329). The combined model fusing valuable ROI-w radiomics features, albumin, and periportal edema exhibited a promising performance (AUC, 0.911). The calibration curves showed good agreement between the actual observations and nomogram predictions. Data Conclusion: The MRI-based radiomics models had a powerful ability to evaluate HIA and the ROI-w radiomics model was comparable to the ROI-r model. Moreover, the radiomics nomogram could be a favorable method to individually estimate HIA in CLD.

A novel radiomics signature based on T2-weighted imaging accurately predicts hepatic inflammation in individuals with biopsy-proven nonalcoholic fatty liver disease: a derivation and independent validation study

“…However, it should be noted that the specialized software of LiverMultiScan TM limits its widespread use, because of necessary payment for this software. Recently, in a small study of 137 Chinese patients with chronic hepatitis B or other chronic liver diseases, the authors found that MRI-based radiomics models yielded good diagnostic performance for identifying hepatic inflammation (24). However, as this study was limited to a single center without any independent external validation, the robustness and generalizability of the findings remain unconfirmed.…”

“…Regarding imaging techniques used for assessing hepatic inflammation, the visual examination of imaging modalities has been used to determine hepatic inflammatory activity in the past (34). However, the high inter-observer variability and the unsatisfactory performance largely limit its use in clinical practice (24). França et al (17) recently proposed a quantitative method of 'intra-voxel incoherent motion diffusion-weighted MRI' for the assessment of hepatic inflammation.…”

“…In our study, radiomics features were extracted only from localized regions in the right liver lobe. Although a localized ROI does not represent the overall changes in liver parenchyma, a radiomics analysis of chronic liver disease by Song et al (24) showed that the radiomics model, based on localized ROIs, yielded comparable diagnostic performance to a model based on the whole liver, suggesting that the quantitative analysis of part of the liver may be sufficient in NAFLD.…”

“…Recent radiomics techniques have shown excellent capability to non-invasively assess liver fibrosis (22,23). However, to the best of our knowledge, there are very few studies that have investigated whether radiomics techniques can also be used to accurately assess hepatic inflammation (24). T2-weighted imaging (T2WI) is a widely available sequence, which is a part of the output from routine upper abdomen MRI scans.…”

Clinical Application of Quantitative MR Imaging in Nonalcoholic Fatty Liver Disease

“…108,109 Some reports used T1 mapping and T2 mapping to assess inflammation and have found some correlation, while others have reported that radiomic models based on T1 values corrected for T2* or T2 weighted sequences have shown promising results. [110][111][112]…”