MRI-measured arterial enhancement volume flags early recurrence after liver cancer surgery

A multicenter retrospective study reports that a single quantitative feature measured automatically on MRI—the fraction of liver tumor volume that enhances in the arterial phase—is independently associated with early recurrence of hepatocellular carcinoma after surgical removal. In the study, published as an open-access article in BMC Medical Imaging, every 15% decrease in preoperative arterial phase enhancement volume fraction was associated with a significantly increased risk of early recurrence, with a hazard ratio of 1.63 (95% confidence interval 1.12–2.37; p = 0.015) in the internal cohort and 2.54 (95% confidence interval 1.18–5.47; p = 0.023) in the external cohort. The published version is an early release that is citable and carries a permanent DOI but remains subject to further editorial edits before the final version of record appears.

The research team analyzed 532 patients with hepatocellular carcinoma who underwent hepatectomy across multiple centers. The cohort was divided into an internal group of 372 patients and an external validation group of 160 patients. The investigators used artificial intelligence techniques to automatically measure the multi-phase enhancement volume on each MRI examination.

From these measurements they derived three variables: the arterial phase enhancement volume fraction (AP_EnVF), the portal venous phase enhancement volume fraction (PV_EnVF), and the delayed phase enhancement volume fraction (DP_EnVF), each quantifying the enhancing portion of tumor volume on the corresponding phase of the contrast-enhanced scan. To identify which features carried independent prognostic information, the researchers performed Lasso-Cox variable selection followed by multivariable Cox regression analyses. The result was strikingly phase-specific.

The arterial phase fraction was the only one of the three measures associated with early recurrence, while the enhancement volume fractions measured in the portal venous and delayed phases showed no significant predictive value, with both p-values exceeding 0.05. The consistency of the arterial-phase association across the internal and external patient groups indicates that the signal was not confined to the dataset used for model development, although the study design establishes an association rather than a causal relationship. Several caveats apply to the findings.

The study is retrospective, meaning the analysis relied on existing imaging and outcome records of patients who underwent hepatectomy rather than on data collected prospectively for this purpose. The reported hazard ratios come from observational associations within the studied cohorts, and the early-release status of the article means the final version may still undergo changes.

Subject of Research: Quantified enhancement volume based on MRI as a prognostic biomarker for early recurrence in hepatocellular carcinoma

Article Title: Quantified enhancement volume based on MRI as a prognostic biomarker for early recurrence in hepatocellular carcinoma

Article References: Tang, Y., Li, D., Hu, H., Li, C., Sun, H., Wang, B., Sun, S., Lv, J., Chen, G., Lu, W., Zuo, L., Liu, E., & Yu, D. (2026). Quantified enhancement volume based on MRI as a prognostic biomarker for early recurrence in hepatocellular carcinoma. BMC Medical Imaging. https://doi.org/10.1186/s12880-026-02976-y

Image Credits: AI Generated

DOI: 10.1186/s12880-026-02976-y

Keywords: Quantified, enhancement, volume, based, prognostic, biomarker, early, recurrence, hepatocellular, carcinoma, scientific research