Habitat imaging before transarterial chemoembolization in hepatocellular carcinoma: Ready for clinical decision-making?

Table 1 Representative studies evaluating imaging-based pretreatment prediction of transarterial chemoembolization response in hepatocellular carcinoma

Ref.	Approach	Outcome	Main message	Main limitation
Kong et al[30], 2021	Pretreatment MRI radiomics nomogram	Early tumor response after TACE	MRI radiomics improved pretreatment response assessment beyond conventional imaging alone	Single-center retrospective design; no habitat-based analysis
Chen et al[31], 2021	Clinical-radiomic model	Objective response to first TACE	Integration of clinical and radiomic variables improved pretreatment stratification	Limited external generalizability
Peng et al[32], 2021	Radiomics plus deep learning	Initial response in intermediate-stage HCC	Hybrid artificial intelligence models may outperform simpler predictive approaches	Limited interpretability and black-box behavior
Vosshenrich et al[33], 2021	CT texture analysis with nested decision-tree model	Response to TACE	Quantitative CT texture analysis showed predictive potential before treatment	No multicenter validation
İnce et al[34], 2023	MRI clinicoradiomic machine-learning models	Local response after TACE	Addition of clinical variables improved performance compared with radiomics alone	Retrospective design and manual workflow
Xi et al[25], 2024	Contrast-enhanced MRI clinical-radiomics model	Short-term efficacy of DEB-TACE	Combined model outperformed imaging-only approaches	Findings limited to the drug-eluting bead setting
Li et al[37], 2024	Tumor growth pattern plus intra- and peritumoral radiomics	Initial TACE response	Peritumoral information improved predictive performance	Retrospective design and center-specific imaging workflow
Lv et al[24], 2026	Habitat imaging plus radiomics plus clinical features	Early response to TACE	Explicit modeling of intratumoral habitats improved predictive discrimination	Requires prospective validation and stronger biological grounding

MRI: Magnetic resonance imaging; TACE: Transarterial chemoembolization; HCC: Hepatocellular carcinoma; CT: Computed tomography; DEB-TACE: Drug-eluting bead transarterial chemoembolization.