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Incremental value of a tumor-radiomics Random Survival Forest score (R1) beyond cohort-specific clinical Cox models (C0) was evaluated within each cohort using 5-fold cross-validation repeated 10 times. External validation was restricted to frozen WAW-trained R1 models (Top-K\u2009=\u20095, 10, 15) applied to HCC-TACE-SEG without refitting; the combined C0\u2009+\u2009R1 model was not externally validated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>WAW-TACE included 162 deaths and HCC-TACE-SEG 86 deaths. In WAW-TACE, C0, R1 Top-K\u2009=\u200915, and C0\u2009+\u2009R1 achieved C-indices of 0.646\u2009\u00b1\u20090.043, 0.593\u2009\u00b1\u20090.049, and 0.639\u2009\u00b1\u20090.045, respectively. Corresponding HCC-TACE-SEG estimates were 0.496\u2009\u00b1\u20090.087, 0.530\u2009\u00b1\u20090.072, and 0.495\u2009\u00b1\u20090.094. Thus, R1 did not consistently improve cohort-specific clinical reference models. In frozen external application, Top-K\u2009=\u20095, 10, and 15 achieved C-indices of 0.463 (95% CI 0.397\u20130.532), 0.535 (0.468\u20130.608), and 0.528 (0.460\u20130.598), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The evaluated models showed no consistent incremental value for OS prediction within these TACE cohorts and limited frozen-model discrimination in the clinically distinct HCC-TACE-SEG cohort. These findings do not support clinical use of these models or establish a general limitation of CT radiomics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00261-026-05830-5","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:09:10Z","timestamp":1791878950000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Limited incremental value and cross-cohort transferability of CT radiomics for survival prediction after TACE in hepatocellular carcinoma"],"prefix":"10.1007","author":[{"given":"Krzysztof","family":"Bartnik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9225-1359","authenticated-orcid":false,"given":"Belgutei","family":"Tsevegmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"5830_CR1","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.1097\/HEP.0000000000000466","volume":"78","author":"AG Singal","year":"2023","unstructured":"Singal AG, Llovet JM, Yarchoan M, Mehta N, Heimbach JK, Dawson LA, et al. 2023. 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