3D fractal dimension analysis of CT imaging for microvascular invasion prediction in hepatocellular carcinoma

Question The predictive value of three-dimensional (3D) fractal dimension (FD) derived from contrast-enhanced CT images for identifying MVI-positive HCC remains unclear. Findings Quantitative indicators derived from fractal analysis were able to predict MVI. The developed model demonstrated improved performance when incorporating fractal dimension. Clinical relevance Fractal analysis based on contrast-enhanced CT is a feasible approach for evaluating MVI and provides additional clinical value for prognostic assessment. It may serve as a reference for preoperative MVI estimation and assist clinicians in executing more tailored therapies.