{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:54:02Z","timestamp":1781585642402,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82372834"],"award-info":[{"award-number":["82372834"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173129"],"award-info":[{"award-number":["82173129"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82302942"],"award-info":[{"award-number":["82302942"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010035","name":"Outstanding Youth Foundation of Jiangsu Province","doi-asserted-by":"publisher","award":["BK20240119"],"award-info":[{"award-number":["BK20240119"]}],"id":[{"id":"10.13039\/501100010035","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>This study aimed to explore the predictive value of intratumoral proton density fat fraction (PDFF) and the clinical efficacy of hepatic arterial infusion chemotherapy (HAIC) combined with anti\u2010programmed cell death protein 1 (anti\u2010PD\u20101) therapy in advanced hepatocellular carcinoma (HCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cohort study, patients with advanced HCC received FOLFOX\u2010HAIC or HAIC combined with anti\u2010PD\u20101 (camrelizumab). Progression\u2010free survival (PFS) was evaluated as the time\u2010to\u2010event outcome, while therapeutic efficacy was assessed using tumor response rates. The Kaplan\u2013Meier method and log\u2010rank test were used to compare PFS. In the MRI\u2010PDFF subset, receiver operating characteristic (ROC) analysis was used to determine the optimal PDFF cutoff for predicting nonresponse (SD or PD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between September 2020 and August 2025, 103 patients were included, of whom 47 received HAIC monotherapy and 56 received HAIC combined with anti\u2010PD\u20101 therapy. The HAIC\u2010PD1 group demonstrated significantly longer PFS compared with the HAIC group (HR 0.423; 95% CI 0.218\u20130.818;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0085), and a higher objective response rate (ORR: 46.4% vs. 21.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). In the MRI\u2010PDFF subset, baseline intratumoral PDFF was associated with treatment response. ROC analysis identified an optimal PDFF cutoff of 2.64% for predicting nonresponse (AUC 0.784; 95% CI 0.664\u20130.903). Patients with PDFF &lt;\u20092.64% achieved a higher ORR and longer PFS compared with those with PDFF \u2265\u20092.64%. Longitudinal analyses showed treatment\u2010dependent changes in PDFF after HAIC\u2010PD1 therapy; however, \u0394PDFF did not differ significantly between responders and nonresponders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HAIC combined with anti\u2010PD\u20101 therapy demonstrated superior efficacy compared with HAIC monotherapy in advanced HCC. Baseline intratumoral PDFF may serve as a promising imaging biomarker associated with treatment response in patients receiving HAIC\u2010PD1 therapy. Its potential prognostic relevance for time\u2010to\u2010event outcomes requires further validation in prospective cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71895","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T16:01:29Z","timestamp":1777305689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intratumoral Proton Density Fat Fraction Predicts the Outcome of\n                    <scp>HAIC<\/scp>\n                    Combined With\n                    <scp>PD<\/scp>\n                    \u20101 Inhibitors in Advanced Hepatocellular Carcinoma"],"prefix":"10.1002","volume":"15","author":[{"given":"Yujie","family":"Ye","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunzheng","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"},{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine  Nanjing China"},{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjun","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1112-6026","authenticated-orcid":false,"given":"Yanchao","family":"Xu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laizhu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yican","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binghua","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"},{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine  Nanjing China"},{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3006-2531","authenticated-orcid":false,"given":"Decai","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Transplantation Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing University  Nanjing China"},{"name":"Division of Hepatobiliary and Transplantation Surgery, 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