Work

AI in predicting the macrotrabecular-massive subtype of HCC and informing treatment selection: a multi-center and prospective validation study

Year: 2026

Type: article

Abstract: The macrotrabecular-massive (MTM) subtype of hepatocellular carcinoma (HCC) is associated with aggressive biology and poor prognosis. We aimed to develop a CT-based artificial intelligence model (DeepCT-MTM) for the noninvasive prediction of MTM-HCC and investigate its prognostic utilities as well as biological underpinnings. A total of 3118 patients with HCC were included from 20 tertiary-care hospitals. DeepCT-MTM was developed and validated among 832 patients with early-stage HCC undergoing resection (the resection set) and extrapolated to 2286 patients (including 480 prospectively-collected ones) with intermediate/advanced-stage HCC receiving IATs. DeepCT-MTM's predictive performance for MTM-HCC was evaluated using the area under the receiver operating characteristic curve (AUC), and its prognostic values were investigated for progression-free survival (PFS) and overall survival (OS). In the external test cohort of the resection set, DeepCT-MTM predicted MTM-HCC with an AUC of 0.845. The DeepCT-MTM-predicted high-risk group had worse PFS and OS across all IAT sets (all P < 0.05).. DeepCT-MTM is effective for noninvasively predicting MTM-HCC and may help selecting patients who benefit from a combination of IAT with immunotherapy and anti-angiogenic therapy. However, prospective validations are warranted for these hypothesis-generating findings.

Source: npj Precision Oncology

DOI: 10.1038/s41698-026-01607-7