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Abstract
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide. Intermediate-stage HCC is often treated with either transcatheter arterial chemoembolisation (TACE) or transcatheter arterial embolisation (TAE). Integrating machine learning (ML) offers the possibility of improving treatment outcomes through enhanced patient selection. This systematic review evaluates the effectiveness of ML models in improving the precision and efficacy of both TACE and TAE for intermediate-stage HCC. A comprehensive search of PubMed, EMBASE, Web of Science, and Cochrane Library databases was conducted for studies applying ML models to TACE and TAE in patients with intermediate-stage HCC. Seven studies involving 4,017 patients were included. All included studies were from China. Various ML models, including deep learning and radiomics, were used to predict treatment response, yielding a high predictive accuracy (AUC 0.90). However, study heterogeneity limited comparisons. While ML shows potential in predicting treatment outcomes, further research with standardised protocols and larger, multi-centre trials is needed for clinical integration.
Highlights
In 2020, there were an estimated 906,000 new cases of primary liver cancer and 830,000 associated deaths. 80% of these cases were due to hepatocellular carcinoma (HCC), making it the most common primary liver cancer [1]
This review looks to outline the current uses of Artificial Intelligence (AI) during transcatheter arterial chemoembolisation (TACE) procedures, critically evaluate its efficacy through these studies and examine important gaps within the existing literature
The use of machine learning (ML) in TACE procedures for HCC shows significant promise, with high predictive accuracy reported across multiple studies
Summary
In 2020, there were an estimated 906,000 new cases of primary liver cancer and 830,000 associated deaths. 80% of these cases were due to hepatocellular carcinoma (HCC), making it the most common primary liver cancer [1]. In 2020, there were an estimated 906,000 new cases of primary liver cancer and 830,000 associated deaths. 80% of these cases were due to hepatocellular carcinoma (HCC), making it the most common primary liver cancer [1]. One-third of these patients with liver cirrhosis will go on to develop HCC in their lifetime [15–17]. HCC treatment is guided by the Barcelona Clinic Liver Cancer (BCLC) staging system. Single lesion less than 2 cm in size with preserved liver function. Single or fewer than 3 nodules, each less than 3 cm in size, with preserved liver function. Portal invasion + /− extra-hepatic spread with preserved liver function
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