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We aimed to develop and evaluate a preoperative radiomics biomarker for noninvasive MVI prediction and postoperative risk stratification of recurrence\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective multicenter study, 567 patients with HCC from four centers were included. Based on pretreatment MRI and clinical variables available before surgery, radiomics models characterising the global tumour region (GTR) and intratumoral heterogeneity (ITH) were developed and integrated into a Fusion model for preoperative prediction of MVI. Discrimination, calibration, and clinical utility were assessed using AUC, calibration curves, and decision\u2010curve analysis (DCA). Prognostic stratification was evaluated using C\u2010index, time\u2010dependent ROC analysis, and Kaplan\u2013Meier analysis of recurrence\u2010free survival, and benchmarked against the Barcelona Clinic Liver Cancer (BCLC), China Liver Cancer (CNLC), and American Joint Committee on Cancer (AJCC) staging systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Fusion model showed higher discrimination than comparators in the validation and external test sets, achieving AUCs of 0.924 and 0.895, respectively. Ablation analyses showed incremental gains with the sequential addition of GTR features, ITH features, and clinical covariates. Fusion score\u2010based stratification identified high\u2010 and low\u2010risk groups with markedly divergent recurrence\u2010free survival. In the external test set, the prognostic model achieved a C\u2010index of 0.766 and time\u2010dependent AUCs of 0.825 at 2\u2009years and 0.878 at 5\u2009years, showing higher discrimination than BCLC, CNLC, and AJCC staging (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Performance remained robust across HBV status, histologic differentiation, and BCLC stage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A radiomics biomarker integrating global tumour phenotype, intratumoral heterogeneity, and preoperative clinical variables enables noninvasive preoperative MVI assessment and may complement morphology\u2010based staging for recurrence risk stratification in HCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70818","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T09:07:08Z","timestamp":1784970428000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative\n                    <scp>MRI<\/scp>\n                    Intratumoral Heterogeneity Radiomics for Microvascular Invasion and Recurrence\u2010Free Survival in\n                    <scp>HCC<\/scp>"],"prefix":"10.1111","volume":"46","author":[{"given":"Ruishan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Radiology The Third Hospital of Mianyang, Sichuan Mental Health Center  Mianyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyang","family":"Xie","sequence":"additional","affiliation":[{"name":"Zhejiang Key Laboratory of Multi\u2010Omics Precision Diagnosis and Treatment of Liver Diseases, Department of General Surgery, Sir Run\u2010Run Shaw Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lv","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Radiology The Third Hospital of Mianyang, Sichuan Mental Health Center  Mianyang 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