{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T01:05:26Z","timestamp":1781831126233,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:00:00Z","timestamp":1758931200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Risk assessment in primary sclerosing cholangitis (PSC) by magnetic resonance imaging (MRI) relies on semi\u2010quantitative analysis, which can result in interpretation variability. Radiomics may offer a quantitative approach for risk stratification. This study aims to explore and validate MRI\u2010derived radiomic features to identify high\u2010risk PSC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study (January 2019\u2013December 2022), consecutive PSC patients undergoing routine gadoxetate disodium\u2010enhanced MRI were recruited. Using PyRadiomics, whole liver parenchyma features were extracted from five MRI sequences according to the Image Biomarker Standardisation Initiative (IBSI). Patients were categorised into risk groups based on the Mayo risk score (MRS) and liver stiffness measurement (LSM). Features associated with high\u2010risk patients were selected and validated in an independent cohort. A survival analysis was conducted in the combined cohort to assess the prognostic value of the radiomic features for clinical events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred and two PSC patients were enrolled in this study. Five radiomics features were associated with high risk in the training cohort. In the validation setting,\n                      <jats:italic>GLRLM\u2010Run Entropy<\/jats:italic>\n                      in the fat\u2010saturation T2 weighted imaging (FS\u2010T2W) sequence was the only significant feature, with an odds ratio of 3.90 (CI 1.46\u201310.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) for MRS and 2.97 (CI 1.33\u20136.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) for LSM. Its prognostic potential on clinical outcome was confirmed by Cox regression analysis in the combined cohort (hazard ratio per 0.1 increase\u2009=\u20091.480, CI 1.226\u20131.786), showing excellent predictive performance (C\u2010index\u2009=\u20090.857).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>GLRLM\u2010Run Entropy<\/jats:italic>\n                      in FS\u2010T2W is a novel radiomics\u2010based biomarker for risk stratification in PSC patients. It is quantitative, standardised, easy to compute and cost\u2010free, positioning it as a potential key innovation in PSC radiology\u2010based biomarkers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Clinicaltrial.gov ID: NC705618145<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70348","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T10:15:15Z","timestamp":1758968115000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Radiomics\u2010Based Prognostication in Primary Sclerosing Cholangitis: A Proof\u2010of\u2010Concept Study"],"prefix":"10.1111","volume":"45","author":[{"given":"Laura","family":"Cristoferi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Center for Autoimmune Liver Diseases European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER), Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Maino","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Fondazione IRCCS San Gerardo dei Tintori  Monza MB Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Paolo","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Bicocca Bioinformatics Biostatistics and Bioimaging Centre\u2010B4, School of Medicine and Surgery University of Milan\u2010Bicocca  Monza MB Italy"},{"name":"ASST Grande Ospedale Metropolitano Niguarda Clinical Research and Innovation Unit  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Ripamonti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Scaravaglio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Savino","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Pesatori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Gerussi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Center for Autoimmune Liver Diseases European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER), Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"},{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Nofit","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Center for Autoimmune Liver Diseases European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER), Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Falco","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"D'Amato","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Monza 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J.Trivedi et\u00a0al. \u201cProspective Validation of the Prognostic Value of Liver Stiffness (LS) Assessed by Fibroscan in Primary Sclerosing Cholangitis (PSC): Interim Analysis of the Ficus Study \u201dIn: AASLD The Liver Meeting 2019 (2019) 33A."},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/HEP.29293"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/S00261\u2010022\u201003655\u20106"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/JMRI.24381"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/HEP.30085"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JHEP.2019.08.013"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.07.032"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.CLINIMAG.2022.01.002"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/MP.16054"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.70348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T14:41:56Z","timestamp":1763044916000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.70348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,27]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/liv.70348"],"URL":"https:\/\/doi.org\/10.1111\/liv.70348","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,27]]},"assertion":[{"value":"2024-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70348"}}