Computed tomography-based radiomics and body composition model for predicting hepatic decompensation.

Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by inflammation and scarring of the bile ducts, which can lead to cirrhosis and hepatic decompensation. The study aimed to explore the potential value of computational radiomics, a field that extracts quantitative features from medical images, in predicting whether or not PSC patients had hepatic decompensation. We used an in-house developed deep learning model called the body composition model, which quantifies body composition from computed tomography (CT) into four compartments: subcutaneous adipose tissue (SAT), skeletal muscle (SKM), visceral adipose tissue (VAT), and intermuscular adipose tissue (IMAT). We extracted radiomics features from all four body composition compartments and used them to build a predictive model in the training cohort. The predictive model demonstrated good performance in validation cohorts for predicting hepatic decompensation, with an accuracy score of 0.97, a precision score of 1.0, and an area under the curve (AUC) score of 0.97. Computational radiomics using CT images shows promise in predicting hepatic decompensation in primary sclerosing cholangitis patients. Our model achieved high accuracy, but predicting future events remains challenging. Further research is needed to validate clinical utility and limitations.