Evidence mapPaperPMID 41807840Full record

ArticleAnnals of surgical oncology2026

CT-Based Nested Habitats Analysis for Early Recurrence Prediction and Risk Stratification in Hepatocellular Carcinoma: Development and Multicenter Validation Across Four Cohorts.

Jinhong Zhao, Miaoping Zhou, Yongjie Zhou, Yongming Tan, Wenjie Jiang, Lufang Tong, Zhili Yang, Liangxia Xiong, Rong Chen, Lianggeng Gong and 4 more

Abstract readMulticenter StudyValidation Study
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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

14 authors.

Jinhong Zhao *Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Miaoping Zhou *Department of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, China.
Yongjie ZhouDepartment of Radiology, Jiangxi Cancer Hospital, Nanchang, Jiangxi, China.
Yongming TanDepartment of Radiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Wenjie JiangDepartment of Radiology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, China.
Lufang TongDepartment of Radiology, The Third Hospital of Quzhou, Quzhou, Zhejiang, China.
Zhili YangDepartment of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, China.
Liangxia XiongDepartment of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Rong ChenDepartment of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Lianggeng GongDepartment of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jinqiu DengSchool of Mathematics and Computational Science, Xiangtan University, Xiangtan, Hunan, China.
Xiang WeiDepartment of Pathology, Jiangxi Cancer Hospital, Nanchang, Jiangxi, China. weixiangty@163.com.
Zhichao ZuoDepartment of Radiology, Xiangtan Central Hospital, Xiangtan, Hunan, China. zuo_z@smail.xtu.edu.cn.
Zhiqiang WangDepartment of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China. 632322558@qq.com.

Funding

The Project of Jiangxi Provincial Health Commission 202610023The Science and Technology Planning Project of the Jiangxi Provincial Administration of Traditional Chinese Medicine 2025021340The Science and Technology Program of Jiangxi Provincial Health Commission 202510320
6 · The paper itself

Abstract

backgroundThe purpose of this study was to develop and validate a computed tomography (CT)-based nested habitats analysis for identifying aggressive tumor subregions and predicting early recurrence in patients with hepatocellular carcinoma (HCC). PATIENTS AND

methodsPatients from three institutions were allocated to a training cohort (n = 372) and an internal validation cohort (n = 160) at a 7:3 ratio. An external validation cohort (n = 169) from a fourth institution was included. Venous-phase CT images underwent nested habitats analysis to locate aggressive subregions. First, a support vector machine classified tumors on the basis of global radiomic features. Then, local features were extracted to construct probability maps, from which aggressive micro-regions were identified using k-means clustering. Features from the highest-risk micro-regions were integrated to generate a nested habitats score. Model performance was evaluated with the area under the curve (AUC) and Kaplan-Meier survival analysis.

resultsThe nested habitats score demonstrated strong predictive ability for early recurrence, achieving AUCs of 0.832 (95% CI 0.778-0.885) in the training cohort, 0.896 (95% CI 0.833-0.959) in the internal validation cohort, and 0.833 (95% CI 0.762-0.905) in the external validation cohort. In multivariable Cox regression, the nested habitats score remained an independent predictor of recurrence-free survival (RFS) (P < 0.05), along with alkaline phosphatase, macrotrabecular-massive HCC, sex, and intratumoral tertiary lymphoid structures. Kaplan-Meier analysis further confirmed significantly shorter RFS among patients with high nested habitats scores or high nomogram-predicted risk (P < 0.05).

conclusionsThe CT-based nested habitats analysis effectively captures intratumoral heterogeneity and accurately predicts early recurrence in HCC. This technique enables precise postoperative risk stratification.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsNeoplasm Recurrence, LocalTomography, X-Ray ComputedAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRadiomicsRisk AssessmentSurvival RateEarly recurrenceHepatocellular carcinomaNested habitatsRisk stratification

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.