Artificial intelligence-driven risk estimation, early detection, diagnostic characterisation and prognosis in hepatitis b-related hepatocellular carcinoma

Table 3 Artificial intelligence for diagnostic characterisation and prognosis

Ref.	Design, region	Population, aetiology and evidence category (n)	Endpoint	Approach	Validation	Performance	Calibration and explainability	Key limitation
Wei et al[33]	Retrospective, China	Resected HCC; recurrence-related (434)	Early recurrence after treatment	MRI radiomics with 3D U-net automated segmentation	Internal validation cohort	C-index 0.706; exceeded BCLC and CNLC staging	Not reported	Post-diagnosis endpoint; single-country
Ji et al[34]	Retrospective, multi-institutional, China	Resected HCC; recurrence-related	Post-resection recurrence	Machine learning on contrast-enhanced CT radiomics	Multi-institutional	Predicted recurrence across institutions	Not reported	Retrospective; feature instability across scanners
Zhao et al[35]	Retrospective, China	HCC after curative resection; recurrence-related	Early recurrence	Deep-learning radiomics on contrast-enhanced MRI	Internal	Hybrid models outperformed single-stream inputs	Not reported	Single-centre; no external validation
Chaudhary et al[36]	Retrospective, public cohorts	Liver cancer; prognostic	Survival and molecular subgroup	Deep-learning multi-omics integration	External replication in independent cohorts	Reproducible prognostic molecular subgroups	Not reported	Omics assays costly and unavailable in high-burden settings
Kucukakcali et al[37]	Case-control, open-access gene expression data	HBV-related HCC vs HBV infection alone; HBV-specific (17 vs 36)	Discrimination of HBV-HCC from HBV alone	Extreme gradient boosting with 10-fold cross-validation	Internal cross-validation	18 genes selected; candidate biomarkers nominated	Not reported	Very small sample; reported accuracy not an estimate of real-world performance

HCC: Hepatocellular carcinoma; MRI: Magnetic resonance imaging; U-net: Convolutional network architecture for biomedical image segmentation; C-index: Harrell concordance index; BCLC: Barcelona Clinic Liver Cancer; CNLC: China Liver Cancer staging system; CT: Computed tomography; HBV: Hepatitis B virus.