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In particular, the prognostic relevance of splenic volume changes after TARE is not fully understood. This study aimed to assess imaging-derived markers\u2014specifically splenic volume dynamics\u2014as predictors of disease progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed laboratory and imaging data from 73 patients with histologically or imaging-confirmed HCC who underwent TARE with Yttrium-90 (\n                      <jats:sup>90<\/jats:sup>\n                      Y) at our institution between January 2012 and September 2022. Inclusion criteria were age\u2009\u2265\u200918 years, availability of baseline and 3-month follow-up imaging, and complete clinical documentation. Patients undergoing liver resection, transplantation, or additional therapies during follow-up were excluded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A relative increase in splenic volume at 3 months was the only independent predictor of progression-free survival (PFS), yielding a ROC-AUC of 0.86 (95%-CI: 0.76\u20130.95). An increase of 18% or more most accurately identified patients with early disease progression (&lt;\u200912 months) with a sensitivity 0.74 and specificity 0.97, outperforming conventional clinical and laboratory parameters, including two-dimensional craniocaudal spleen measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Automated splenic volumetry showed superior prognostic value over traditional markers in HCC patients treated with TARE. A post-treatment increase in spleen volume represents an additional, robust, and readily accessible imaging biomarker for early risk stratification and individualized treatment planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07792-8","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:19:06Z","timestamp":1771287546000},"page":"3904-3914","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Fully automated spleen segmentation predicts progression-free survival in HCC patients following transarterial radioembolization"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2452-4389","authenticated-orcid":false,"given":"Lisa","family":"Steinhelfer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Jungmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Endroes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Nickel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Schweizer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Ehmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Haller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Walter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Spaeth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Einw\u00e4chter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannis","family":"Bodden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Knorr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Eiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rickmer","family":"Braren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"7792_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, et al. 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(consultant, research funding), Novartis\/AAA (consultant, speaker), Telix (consultant), Bayer (consultant, research funding), RayzeBio (consultant), Point Biopharma (consultant), Eckert-Ziegler (speaker) and Janssen Pharmaceuticals (consultant, speakers bureau), Parexel (image review) and Bioclinica (image review) outside the submitted work and a patent application for rhPSMA.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}