Evaluate the Microvascular Invasion of Hepatocellular Carcinoma (≤5 cm) and Recurrence Free Survival with Gadoxetate Disodium‐Enhanced MRI‐Based Habitat Imaging

BACKGROUND: Tumors are heterogenous and consist of subregions, also known as tumoral habitats, each exhibiting varied biological characteristics. Each habitat corresponds to a cluster of tissue sharing similar structural, metabolic, or functional characteristics. The habitat imaging technique facilitates both the visualization and quantification of these tumoral habitats. PURPOSE: To evaluate the microvascular invasion (MVI) in hepatocellular carcinoma (HCC) (≤5 cm) and assess the recurrence-free survival (RFS) using gadoxetate disodium-enhanced MRI-based habitat imaging. STUDY TYPE: Retrospective. SUBJECTS: 180 patients (52.9 years ± 11.7, 156 men) with HCC. FIELD STRENGTH/SEQUENCE: 1.5T/contrast-enhanced T1-weighted gradient-echo sequence. ASSESSMENT: The enhancement ratio of signal intensity at the arterial phase (AER) and hepatobiliary phase (HBPER) were calculated. The HCC lesions and their peritumoral tissues of 3, 5, and 7 mm were encoded into four habitats. The volume fraction of each habitat was then quantified. The diagnostic performance was assessed using the receiver operating characteristic analysis with 5-fold cross-validation. The RFS was evaluated with Kaplan-Meier curves. RESULTS: and tumor diameter, demonstrating high diagnostic accuracy. The area under the curve from 5-fold cross-validation ranged from 0.880 to 1.000. Additionally, the nomogram model demonstrated high efficacy in risk stratification for RFS. CONCLUSION: Habitat imaging of HCC and its peritumoral microenvironment has the potential for noninvasive and preoperative identification of MVI and prognostic assessment. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.