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Background <p>To evaluate treatment response in hepatocellular carcinoma (HCC) following Yttrium-90 (<sup>90</sup>Y) radioembolization by integrating pre-treatment contrast-enhanced magnetic resonance imaging (CE-MRI) radiomics with post-treatment <sup>90</sup>Y positron emission tomography (PET) dosimetry.</p> Materials and methods <p>This retrospective study included 57 patients with pathologically confirmed HCC. All patients underwent CE-MRI within 4–6 weeks before <sup>90</sup>Y transarterial radioembolization (TARE), followed by <sup>90</sup>Y PET/CT within 24&#xa0;h post-treatment. Tumor response was assessed at three months using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Radiomic features extracted from CE-MRI and 24&#xa0;h tumor absorbed dose parameters from <sup>90</sup>Y PET/CT were analyzed to predict treatment response, classifying patients as responders or non-responders.</p> Results <p>Based on mRECIST criteria, 32 patients were classified as responders (all partial response), while 25 were non-responders (20 stable disease, 5 progressive disease). 24-hour average absorbed dose is independent predictive factors for treatment response (OR = 1.06, <i>p</i> = 0.006). The combined model, incorporating clinical characteristics and MRI-derived radiomic features, achieved a sensitivity of 88% (28/32) [95% CI, 71%–96%], specificity of 68% (17/25) [95% CI, 46%–85%], and accuracy of 79% (45/57) [95% CI, 66%–89%].</p> Conclusion <p>The integration of pre-treatment CE-MRI radiomics with post-treatment <sup>90</sup>Y PET imaging provides complementary insights into tumor biology and therapeutic efficacy. Early tumor absorbed dose metrics derived from <sup>90</sup>Y PET, together with specific CE-MRI radiomic features, show strong correlations with treatment response and may serve as valuable predictive biomarkers to guide patient stratification and optimize radioembolization strategies in HCC.</p>

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MRI radiomics and 90Y PET dosimetry for predicting hepatocellular carcinoma response after radioembolization

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Wenyu Huang,
  • Jie Ding,
  • Hongzhen Yuan,
  • Zhidong Li,
  • Huai Li,
  • Yinglang Zeng

摘要

Background

To evaluate treatment response in hepatocellular carcinoma (HCC) following Yttrium-90 (90Y) radioembolization by integrating pre-treatment contrast-enhanced magnetic resonance imaging (CE-MRI) radiomics with post-treatment 90Y positron emission tomography (PET) dosimetry.

Materials and methods

This retrospective study included 57 patients with pathologically confirmed HCC. All patients underwent CE-MRI within 4–6 weeks before 90Y transarterial radioembolization (TARE), followed by 90Y PET/CT within 24 h post-treatment. Tumor response was assessed at three months using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Radiomic features extracted from CE-MRI and 24 h tumor absorbed dose parameters from 90Y PET/CT were analyzed to predict treatment response, classifying patients as responders or non-responders.

Results

Based on mRECIST criteria, 32 patients were classified as responders (all partial response), while 25 were non-responders (20 stable disease, 5 progressive disease). 24-hour average absorbed dose is independent predictive factors for treatment response (OR = 1.06, p = 0.006). The combined model, incorporating clinical characteristics and MRI-derived radiomic features, achieved a sensitivity of 88% (28/32) [95% CI, 71%–96%], specificity of 68% (17/25) [95% CI, 46%–85%], and accuracy of 79% (45/57) [95% CI, 66%–89%].

Conclusion

The integration of pre-treatment CE-MRI radiomics with post-treatment 90Y PET imaging provides complementary insights into tumor biology and therapeutic efficacy. Early tumor absorbed dose metrics derived from 90Y PET, together with specific CE-MRI radiomic features, show strong correlations with treatment response and may serve as valuable predictive biomarkers to guide patient stratification and optimize radioembolization strategies in HCC.