{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:15:28Z","timestamp":1789654528806,"version":"4.0.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":54,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"DOI":"10.1186\/s12880-026-02371-7","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:35:18Z","timestamp":1778315718000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can incorporating preoperative arterial enhancement ratio map into habitat analysis predict TACE refractoriness in unresectable hepatocellular carcinoma?"],"prefix":"10.1186","volume":"26","author":[{"given":"Yan","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlong","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dajing","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"issue":"3","key":"2371_CR1","first-page":"229","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229\u201363.","journal-title":"CA Cancer J Clin"},{"issue":"3","key":"2371_CR2","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1016\/j.jhep.2021.11.018","volume":"76","author":"M Reig","year":"2022","unstructured":"Reig M, Forner A, Rimola J, Ferrer-F\u00e0brega J, Burrel M, Garcia-Criado \u00c1, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. J Hepatol. 2022;76(3):681\u201393.","journal-title":"J Hepatol"},{"key":"2371_CR3","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ctrv.2018.11.002","volume":"72","author":"JL Raoul","year":"2019","unstructured":"Raoul JL, Forner A, Bolondi L, Cheung TT, Kloeckner R, de Baere T. Updated use of TACE for hepatocellular carcinoma treatment: How and when to use it based on clinical evidence. Cancer Treat Rev. 2019;72:28\u201336.","journal-title":"Cancer Treat Rev"},{"issue":"3","key":"2371_CR4","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1159\/000514174","volume":"10","author":"M Kudo","year":"2021","unstructured":"Kudo M, Kawamura Y, Hasegawa K, Tateishi R, Kariyama K, Shiina S, et al. Management of Hepatocellular Carcinoma in Japan: JSH Consensus Statements and Recommendations 2021 Update. Liver Cancer. 2021;10(3):181\u2013223.","journal-title":"Liver Cancer"},{"issue":"4","key":"2371_CR5","doi-asserted-by":"publisher","first-page":"740","DOI":"10.14218\/JCTH.2021.00336","volume":"10","author":"S Zhang","year":"2022","unstructured":"Zhang S, Wang WS, Zhong BY, Ni CF. Subsequent Treatment after Transarterial Chemoembolization Failure\/Refractoriness: A Review Based on Published Evidence. J Clin Transl Hepatol. 2022;10(4):740\u20137.","journal-title":"J Clin Transl Hepatol"},{"issue":"1","key":"2371_CR6","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.1186\/s12885-024-13199-1","volume":"24","author":"R Ashour","year":"2024","unstructured":"Ashour R, Rewisha E, Rady MA, Elkhadry SW, Abdelhalim H, Atef M. Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization. BMC Cancer. 2024;24(1):1466.","journal-title":"BMC Cancer"},{"issue":"15","key":"2371_CR7","doi-asserted-by":"publisher","first-page":"4589","DOI":"10.7150\/jca.44847","volume":"11","author":"K Hu","year":"2020","unstructured":"Hu K, Lu S, Li M, Zhang F, Tang B, Yuan J, et al. A Novel Pre-treatment Model Predicting Risk of Developing Refractoriness to Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma. J Cancer. 2020;11(15):4589\u201396.","journal-title":"J Cancer"},{"issue":"1","key":"2371_CR8","doi-asserted-by":"publisher","first-page":"447","DOI":"10.21037\/qims-23-963","volume":"14","author":"H Li","year":"2024","unstructured":"Li H, Kang W, Rong P. Development and validation of a clinical factors and body fat distribution-based nomogram to predict refractoriness of transarterial chemoembolization in hepatocellular carcinoma. Quant Imaging Med Surg. 2024;14(1):447\u201361.","journal-title":"Quant Imaging Med Surg"},{"key":"2371_CR9","doi-asserted-by":"publisher","first-page":"633590","DOI":"10.3389\/fmolb.2021.633590","volume":"8","author":"TC Wang","year":"2021","unstructured":"Wang TC, An TZ, Li JX, Zhang ZS, Xiao YD. Development and Validation of a Predictive Model for Early Refractoriness of Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma. Front Mol Biosci. 2021;8:633590.","journal-title":"Front Mol Biosci"},{"issue":"2","key":"2371_CR10","doi-asserted-by":"publisher","first-page":"189","DOI":"10.3748\/wjg.v27.i2.189","volume":"27","author":"XK Niu","year":"2021","unstructured":"Niu XK, He XF. Development of a computed tomography-based radiomics nomogram for prediction of transarterial chemoembolization refractoriness in hepatocellular carcinoma. World J Gastroenterol. 2021;27(2):189\u2013207.","journal-title":"World J Gastroenterol"},{"key":"2371_CR11","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.2147\/CMAR.S486561","volume":"17","author":"Y Dong","year":"2025","unstructured":"Dong Y, Hu J, Meng X, Yang B, Peng C, Zhao W. Development and Validation of a Radiomics Nomogram Based on Magnetic Resonance Imaging and Clinicoradiological Factors to Predict HCC TACE Refractoriness. Cancer Manag Res. 2025;17:1441\u201355.","journal-title":"Cancer Manag Res"},{"issue":"1","key":"2371_CR12","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12943-024-02101-z","volume":"23","author":"YT Chan","year":"2024","unstructured":"Chan YT, Zhang C, Wu J, Lu P, Xu L, Yuan H, et al. Biomarkers for diagnosis and therapeutic options in hepatocellular carcinoma. Mol Cancer. 2024;23(1):189.","journal-title":"Mol Cancer"},{"issue":"4","key":"2371_CR13","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1016\/j.acra.2024.10.007","volume":"32","author":"Z Huang","year":"2025","unstructured":"Huang Z, Huang W, Jiang L, Zheng Y, Pan Y, Yan C, et al. Decision Fusion Model for Predicting Microvascular Invasion in Hepatocellular Carcinoma Based on Multi-MR Habitat Imaging and Machine-Learning Classifiers. Acad Radiol. 2025;32(4):1971\u201380.","journal-title":"Acad Radiol"},{"issue":"5","key":"2371_CR14","doi-asserted-by":"publisher","first-page":"3215","DOI":"10.1007\/s00330-023-10339-2","volume":"34","author":"Y Zhang","year":"2024","unstructured":"Zhang Y, Chen J, Yang C, Dai Y, Zeng M. Preoperative prediction of microvascular invasion in hepatocellular carcinoma using diffusion-weighted imaging-based habitat imaging. Eur Radiol. 2024;34(5):3215\u201325.","journal-title":"Eur Radiol"},{"issue":"10","key":"2371_CR15","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s11547-023-01695-6","volume":"128","author":"Y Zhang","year":"2023","unstructured":"Zhang Y, Yang C, Sheng R, Dai Y, Zeng M. Predicting the recurrence of hepatocellular carcinoma (\u2264\u20095\u00a0cm) after resection surgery with promising risk factors: habitat fraction of tumor and its peritumoral micro-environment. Radiol Med. 2023;128(10):1181\u201391.","journal-title":"Radiol Med"},{"key":"2371_CR16","doi-asserted-by":"crossref","unstructured":"Cai W, Zhu Y, Li D, Wang B, Ma X, Zhao X. Intratumoral heterogeneity of CT enhancement for component prediction and prognostic significance in combined hepatocellular carcinoma\u2013cholangiocarcinoma. Eur Radiol. 2025.","DOI":"10.1007\/s00330-025-12034-w"},{"key":"2371_CR17","doi-asserted-by":"crossref","unstructured":"Chang Y, Jeong SW, Young Jang J, Jae Kim Y. Recent updates of transarterial chemoembolilzation in hepatocellular carcinoma. Int J Mol Sci. 2020;21(21).","DOI":"10.3390\/ijms21218165"},{"issue":"2","key":"2371_CR18","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1007\/s00261-012-9952-9","volume":"38","author":"C Bartolozzi","year":"2013","unstructured":"Bartolozzi C, Battaglia V, Bargellini I, Bozzi E, Campani D, Pollina LE, et al. Contrast-enhanced magnetic resonance imaging of 102 nodules in cirrhosis: correlation with histological findings on explanted livers. Abdom Imaging. 2013;38(2):290\u20136.","journal-title":"Abdom Imaging"},{"key":"2371_CR19","doi-asserted-by":"publisher","first-page":"957737","DOI":"10.3389\/fonc.2022.957737","volume":"12","author":"W Zhou","year":"2022","unstructured":"Zhou W, Lv Y, Hu X, Luo Y, Li J, Zhu H, et al. Study on the changes of CT texture parameters before and after HCC treatment in the efficacy evaluation and survival predication of patients with HCC. Front Oncol. 2022;12:957737.","journal-title":"Front Oncol"},{"key":"2371_CR20","doi-asserted-by":"crossref","unstructured":"Chernyak V, Fowler KJ, Kamaya A, Kielar AZ, Elsayes KM, Bashir MR, et al. Version 2018: imaging of hepatocellular carcinoma in at-risk patients. Radiology. Liver Imaging Reporting and Data System (LI-RADS). 2018;289(3):816\u201330.","DOI":"10.1148\/radiol.2018181494"},{"issue":"5","key":"2371_CR21","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1111\/liv.15231","volume":"42","author":"H Jiang","year":"2022","unstructured":"Jiang H, Wei J, Fu F, Wei H, Qin Y, Duan T, et al. Predicting microvascular invasion in hepatocellular carcinoma: A dual-institution study on gadoxetate disodium-enhanced MRI. Liver Int. 2022;42(5):1158\u201372.","journal-title":"Liver Int"},{"issue":"2","key":"2371_CR22","doi-asserted-by":"publisher","first-page":"e221835","DOI":"10.1148\/radiol.221835","volume":"307","author":"H Jiang","year":"2023","unstructured":"Jiang H, Wei H, Yang T, Qin Y, Wu Y, Chen W, et al, et al. VICT2 Trait: Prognostic Alternative to Peritumoral Hepatobiliary Phase Hypointensity in HCC. Radiology. 2023;307(2):e221835.","journal-title":"Radiology"},{"issue":"1","key":"2371_CR23","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1016\/j.jhep.2020.08.013","volume":"74","author":"H Rhee","year":"2021","unstructured":"Rhee H, Cho ES, Nahm JH, Jang M, Chung YE, Baek SE, et al. Gadoxetic acid-enhanced MRI of macrotrabecular-massive hepatocellular carcinoma and its prognostic implications. J Hepatol. 2021;74(1):109\u201321.","journal-title":"J Hepatol"},{"issue":"6","key":"2371_CR24","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1038\/nbt1306","volume":"25","author":"E Segal","year":"2007","unstructured":"Segal E, Sirlin CB, Ooi C, Adler AS, Gollub J, Chen X, et al. Decoding global gene expression programs in liver cancer by noninvasive imaging. Nat Biotechnol. 2007;25(6):675\u201380.","journal-title":"Nat Biotechnol"},{"issue":"2","key":"2371_CR25","first-page":"432","volume":"279","author":"M Renzulli","year":"2016","unstructured":"Renzulli M, Brocchi S, Cucchetti A, Mazzotti F, Mosconi C, Sportoletti C, et al. Can Current Preoperative Imaging Be Used to Detect Microvascular Invasion of. Hepatocellular Carcinoma? Radiol. 2016;279(2):432\u201342.","journal-title":"Hepatocellular Carcinoma? Radiol"},{"issue":"3","key":"2371_CR26","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.jhep.2017.04.024","volume":"67","author":"S Lee","year":"2017","unstructured":"Lee S, Kim SH, Lee JE, Sinn DH, Park CK. Preoperative gadoxetic acid-enhanced MRI for predicting microvascular invasion in patients with single hepatocellular carcinoma. J Hepatol. 2017;67(3):526\u201334.","journal-title":"J Hepatol"},{"issue":"2","key":"2371_CR27","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1148\/radiol.15142394","volume":"276","author":"C An","year":"2015","unstructured":"An C, Kim DW, Park YN, Chung YE, Rhee H, Kim MJ. Single Hepatocellular Carcinoma: Preoperative MR Imaging to Predict Early Recurrence after Curative Resection. Radiology. 2015;276(2):433\u201343.","journal-title":"Radiology"},{"issue":"3","key":"2371_CR28","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1111\/hepr.13446","volume":"50","author":"K Maesaka","year":"2020","unstructured":"Maesaka K, Sakamori R, Yamada R, Tahata Y, Urabe A, Shigekawa M, et al. Hypovascular hepatic nodules as a predictive factor for transcatheter arterial chemoembolization refractoriness in hepatocellular carcinoma. Hepatol Res. 2020;50(3):365\u201373.","journal-title":"Hepatol Res"},{"issue":"2","key":"2371_CR29","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.jhep.2019.09.026","volume":"72","author":"JM Llovet","year":"2020","unstructured":"Llovet JM, Lencioni R. mRECIST for HCC: Performance and novel refinements. J Hepatol. 2020;72(2):288\u2013306.","journal-title":"J Hepatol"},{"issue":"4","key":"2371_CR30","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s10456-017-9562-9","volume":"20","author":"C Viallard","year":"2017","unstructured":"Viallard C, Larriv\u00e9e B. Tumor angiogenesis and vascular normalization: alternative therapeutic targets. Angiogenesis. 2017;20(4):409\u201326.","journal-title":"Angiogenesis"},{"issue":"3","key":"2371_CR31","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/j.jhep.2019.05.005","volume":"71","author":"DH Kim","year":"2019","unstructured":"Kim DH, Choi SH, Byun JH, Kang JH, Lim YS, Lee SJ, et al. Arterial subtraction images of gadoxetate-enhanced MRI improve diagnosis of early-stage hepatocellular carcinoma. J Hepatol. 2019;71(3):534\u201342.","journal-title":"J Hepatol"},{"issue":"2","key":"2371_CR32","doi-asserted-by":"publisher","first-page":"e230527","DOI":"10.1148\/radiol.230527","volume":"309","author":"H Jiang","year":"2023","unstructured":"Jiang H, Yang C, Chen Y, Wang Y, Wu Y, Chen W, et al. Development of a Model including MRI Features for Predicting Advanced-stage Recurrence of Hepatocellular Carcinoma after Liver Resection. Radiology. 2023;309(2):e230527.","journal-title":"Radiology"},{"issue":"3","key":"2371_CR33","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1002\/cam4.1330","volume":"7","author":"G Dong","year":"2018","unstructured":"Dong G, Zheng QD, Ma M, Wu SF, Zhang R, Yao RR, et al. Angiogenesis enhanced by treatment damage to hepatocellular carcinoma through the release of GDF15. Cancer Med. 2018;7(3):820\u201330.","journal-title":"Cancer Med"},{"issue":"3","key":"2371_CR34","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1007\/s00330-019-06499-9","volume":"30","author":"TH Kim","year":"2020","unstructured":"Kim TH, Woo S, Han S, Suh CH, Lee DH, Lee JM. Hepatobiliary phase hypointense nodule without arterial phase hyperenhancement: are they at risk of HCC recurrence after ablation or surgery? A systematic review and meta-analysis. Eur Radiol. 2020;30(3):1624\u201333.","journal-title":"Eur Radiol"},{"issue":"8","key":"2371_CR35","doi-asserted-by":"publisher","first-page":"5064","DOI":"10.1007\/s00330-022-08623-8","volume":"32","author":"HJ Park","year":"2022","unstructured":"Park HJ, Lee TY, Kim SY, Kim MJ, Singal AG, Lee SJ, et al. Hypervascular transformation of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement on gadoxetic acid-enhanced MRI: long-term follow-up in a surveillance cohort. Eur Radiol. 2022;32(8):5064\u201374.","journal-title":"Eur Radiol"},{"key":"2371_CR36","doi-asserted-by":"publisher","first-page":"1014653","DOI":"10.3389\/fonc.2022.1014653","volume":"12","author":"WL Xia","year":"2022","unstructured":"Xia WL, Xu SJ, Guo Y, Zhao XH, Hu HT, Zhao Y, et al. Plasma arginase-1 as a predictive marker for early transarterial chemoembolization refractoriness in unresectable hepatocellular carcinoma. Front Oncol. 2022;12:1014653.","journal-title":"Front Oncol"},{"issue":"7","key":"2371_CR37","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1007\/s00270-024-03730-z","volume":"47","author":"C Yang","year":"2024","unstructured":"Yang C, Yang HC, Luo YG, Li FT, Cong TH, Li YJ, et al. Predicting Survival Using Whole-Liver MRI Radiomics in Patients with Hepatocellular Carcinoma After TACE Refractoriness. Cardiovasc Intervent Radiol. 2024;47(7):964\u201377.","journal-title":"Cardiovasc Intervent Radiol"},{"issue":"1","key":"2371_CR38","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s12672-025-01955-z","volume":"16","author":"Q He","year":"2025","unstructured":"He Q, Xiong Y, Yang X, Yu Y, Chen Z. Molecular subtyping combined with multiomics analysis to study correlation between TACE refractoriness and tumor stemness in hepatocellular carcinoma. Discov Oncol. 2025;16(1):197.","journal-title":"Discov Oncol"}],"container-title":["BMC Medical Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12880-026-02371-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02371-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12880-026-02371-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:12:46Z","timestamp":1782965566000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12880-026-02371-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,9]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2371"],"URL":"https:\/\/doi.org\/10.1186\/s12880-026-02371-7","relation":{},"ISSN":["1471-2342"],"issn-type":[{"value":"1471-2342","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,9]]},"assertion":[{"value":"28 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University, which waived the requirement for written informed consent owing to the use of deidentified retrospective data. The study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"322"}}