Deep learning-enhanced peritumoral radiomics predicts early recurrence after hepatocellular carcinoma ablation: A two-center study

doi:10.4251/wjgo.122464

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Oct 15, 2026; 18(10): 122464
Published online Oct 15, 2026. doi: 10.4251/wjgo.122464

Table 1 Clinical and image characteristics of patients in different cohorts, n (%)

Item	Training (n = 155)	Internal validation (n = 67)	External validation (n = 74)	P value
Tumor size (cm)	2.91 (1.64)	2.68 (0.98)	2.70 (1.18)	0.408
Age (years)	57.9 (11.1)	58.8 (12.4)	58.6 (12.0)	0.853
Sex				0.833
Female	30 (19.4)	13 (19.4)	12 (16.2)
Male	125 (80.6)	54 (80.6)	62 (83.8)
HBV				0.435
Positive	53 (34.2)	29 (43.3)	27 (36.5)
Negative	102 (65.8)	38 (56.7)	47 (63.5)
Cirrhosis				0.261
Positive	28 (18.1)	17 (25.4)	11 (14.9)
Negative	127 (81.9)	50 (74.6)	63 (85.1)
N				0.949
< 1.8	64 (41.3)	24 (35.8)	28 (37.8)
1.8-6.3	89 (57.4)	42 (62.7)	45 (60.8)
> 6.3	2 (1.29)	1 (1.49)	1 (1.35)
L				0.583
≥ 1.1	67 (43.2)	31 (46.3)	28 (37.8)
< 1.1	88 (56.8)	36 (53.7)	46 (62.2)
ALT				0.085
≤ 50	115 (74.2)	47 (70.1)	63 (85.1)
> 50	40 (25.8)	20 (29.9)	11 (14.9)
AST				0.347
> 40	68 (43.9)	27 (40.3)	25 (33.8)
≤ 40	87 (56.1)	40 (59.7)	49 (66.2)
GGT				0.805
≤ 60	85 (54.8)	38 (56.7)	38 (51.4)
> 60	70 (45.2)	29 (43.3)	36 (48.6)
GLB				0.444
≤ 35	122 (78.7)	52 (77.6)	63 (85.1)
> 35	33 (21.3)	15 (22.4)	11 (14.9)
HbsAg				0.757
Positive	28 (18.1)	13 (19.4)	11 (14.9)
Negative	127 (81.9)	54 (80.6)	63 (85.1)
AFP				0.167
< 40	39 (25.2)	20 (29.9)	15 (20.3)
40-400	92 (59.4)	30 (44.8)	47 (63.5)
> 400	24 (15.5)	17 (25.4)	12 (16.2)
Np				0.933
< 1.8	31 (20.0)	10 (14.9)	14 (18.9)
1.8-6.3	70 (45.2)	33 (49.3)	34 (45.9)
> 6.3	54 (34.8)	24 (35.8)	26 (35.1)
Lp				0.968
≥ 1.1	101 (65.2)	43 (64.2)	49 (66.2)
< 1.1	54 (34.8)	24 (35.8)	25 (33.8)
ALTp				0.504
≤ 50	33 (21.3)	13 (19.4)	20 (27.0)
> 50	122 (78.7)	54 (80.6)	54 (73.0)
ASTp				0.483
> 40	136 (87.7)	62 (92.5)	64 (86.5)
≤ 40	19 (12.3)	5 (7.46)	10 (13.5)
GGTp				0.965
≤ 60	92 (59.4)	41 (61.2)	44 (59.5)
> 60	63 (40.6)	26 (38.8)	30 (40.5)
GLBp				0.972
≤ 35	115 (74.2)	50 (74.6)	54 (73.0)
> 35	40 (25.8)	17 (25.4)	20 (27.0)
Capsule appearance				0.136
Positive	97 (62.6)	39 (58.2)	36 (48.6)
Negative	58 (37.4)	28 (41.8)	38 (51.4)
Intratumor vascularity				0.811
Positive	60 (38.7)	28 (41.8)	27 (36.5)
Negative	95 (61.3)	39 (58.2)	47 (63.5)
Tumor growth patter				0.612
Positive	113 (72.9)	53 (79.1)	56 (75.7)
Negative	42 (27.1)	14 (20.9)	18 (24.3)
Intratumor necrosis				0.781
Positive	92 (59.4)	39 (58.2)	47 (63.5)
Negative	63 (40.6)	28 (41.8)	27 (36.5)
PACE				0.607
Positive	123 (79.4)	54 (80.6)	55 (74.3)
Negative	32 (20.6)	13 (19.4)	19 (25.7)
Tumor margin				0.648
Positive	100 (64.5)	39 (58.2)	45 (60.8)
Negative	55 (35.5)	28 (41.8)	29 (39.2)
Ablation method				0398
RFA	44 (28.4)	21 (31.3)	16 (21.6)
MWA	111 (71.6)	46 (68.7)	58 (7.4)
PFS				0.659
Absent	93 (60.0)	41 (61.2)	49 (66.2)
Present	62 (40.0)	26 (38.8)	25 (33.8)

HBV: Hepatitis B virus; N: Neutrophil; L: Lymphocyte; ALT: Alanine transferase; AST: Aspartate transferase; GGT: Gammaglutamyl transferase; GLB: Globulin; HbsAg: Hepatitis B surface antigen; AFP: Alpha fetoprotein; Np: Postoperative neutrophil; Lp: Postoperative lymphocyte; ALTp: Postoperative alanine transferase; ASTp: Postoperative aspartate transferase; GGTp: Postoperative gammaglutamyl transferase; GLBp: Postoperative globulin; PACE: Peritumoral arterial contrast enhancement; RFA: Radiofrequency ablation; MWA: Microwave ablation; PFS: Progression-free survival.

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Table 2 Feature selection results from univariate and multivariate analysis

Name	Univariable			Multivariable
Name	OR	95%CI	P value	OR	95%CI	P value
Np
< 1.8	-	-	-	-	-	-
1.8-6.3	0.70	0.30-1.64	0.416	0.72	0.29-1.77	0.476
> 6.3	0.39	0.16-0.99	0.046	0.29	0.10-0.80	0.017
IV
Positive	-	-	-	-	-	-
Negative	2.28	1.14-4.54	0.02	1.67	0.78-3.57	0.19
IN
Positive	-	-	-	-	-	-
Negative	2.13	1.10-4.12	0.024	2.55	1.17-5.57	0.018

OR: Odds ratio; Np: Postoperative neutrophil; IV: Intratumorvascularity; IN: Intratumornecrosis.

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Table 3 The DeLong test comparisons among different models in the training, internal validation, and external validation cohorts

Model		Training		Internal validation		External validation
Model		Z value	P value	Z value	P value	Z value	P value
Cli	10 mm	-3.916	< 0.0001	-2.310	0.0208	-2.212	0.0230
Cli	Combined	-4.948	< 0.0001	-3.498	0.0005	-3.035	0.0024
10 mm	Combined	-1.086	0.2773	-1.063	0.2878	-0.798	0.4249

Cli: Clinical imaging model; 10 mm: 10 mm peritumoral model; Combined: Model integrating clinical imaging features and 10 mm per itumoral features.

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Citation: Li YH, Yao L, Qian GX, Lei XD, Tang ZQ, Guo BY, Du R, Zhu Y, Jia WD. Deep learning-enhanced peritumoral radiomics predicts early recurrence after hepatocellular carcinoma ablation: A two-center study. World J Gastrointest Oncol 2026; 18(10): 122464
URL: https://www.wjgnet.com/1948-5204/full/v18/i10/122464.htm
DOI: https://dx.doi.org/10.4251/wjgo.122464

Li YH, Yao L, Qian GX, Lei XD, Tang ZQ, Guo BY, Du R, Zhu Y, Jia WD. Deep learning-enhanced peritumoral radiomics predicts early recurrence after hepatocellular carcinoma ablation: A two-center study. World J Gastrointest Oncol 2026; 18(10): 122464 [DOI: 10.4251/wjgo.122464]

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