Preoperative prediction of microvascular invasion in hepatocellular carcinoma ≤5 cm based on…

Cohort studyFrontiers in oncology· 2026

Preoperative prediction of microvascular invasion in hepatocellular carcinoma ≤5 cm based on contrast-enhanced ultrasound features and LI-RADS categorization: a multicenter study.

Qian Zhang, Chuan Pang, Zhilong Liu … Liping Liu

Abdominal & Body ImagingCohort studyPrognosisQ2IF 3.1

Combined ultrasound and LI-RADS model accurately predicts microvascular invasion in hepatocellular carcinoma ≤5 cm

Preoperative prediction of microvascular invasion in hepatocellular carcinoma ≤5 cm based on contrast-enhanced ultrasound features and LI-RADS categorization: a multicenter study.

Qian Zhang … Liping Liu

Frontiers in oncology · 2026

Purpose

To investigate the predictive value of contrast-enhanced ultrasound (contrast-enhanced ultrasound) features combined with Liver Imaging Reporting and Data System (LI-RADS) categorization for microvascular invasion (microvascular invasion) in hepatocellular carcinoma (hepatocellular carcinoma) ≤5 cm.

Methods

This multicenter retrospective study enrolled adult patients with hepatocellular carcinoma ≤5 cm who underwent contrast-enhanced ultrasound between January 2018 and December 2025.

n = 261 patients

Results

AUC of 0.880, 1.0 is perfect prediction, indicates strong accuracy

AUC 0.88 (95% CI 0.83 to 0.93)

CI excludes the null - significant

More results

Patients were divided into a derivation cohort (n=209) and an external validation cohort (n=52).

85 patients (32.57%) were microvascular invasion-positive.

Calibration curves revealed excellent agreement between the model's predicted probability of microvascular invasion and the actual observed outcomes.

More results

Decision curve analysis confirmed the excellent net benefits.

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Conclusion

This model can noninvasive preoperative prediction of microvascular invasion risk in patients with hepatocellular carcinoma ≤5 cm, offering a reliable reference for clinicians in developing personalized treatment strategies.

Preoperative prediction of microvascular invasion in hepatocellular carcinoma ≤5 cm based on contrast-enhanced ultrasound features and LI-RADS categorization: a multicenter study.

Preoperative prediction of microvascular invasion in hepatocellular carcinoma ≤5 cm based on contrast-enhanced ultrasound features and LI-RADS categorization: a multicenter study.

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