Brilliance 128

CT was performed 1–2 months after TACE using a multi-detector scanner (Somatom Definition AS + 128, Siemens Healthineers, Erlangen, Germany; Aquilion one 320, Toshiba Medical Systems, Tokyo, Japan; or Brilliance 128, Philips Healthcare, Best, The Netherlands). Contrast-enhanced scanning was conducted by intravenously injecting a bolus of a non-ionic contrast agent (1.5 mL/kg; Ultravist 350, Bayer Healthcare, Berlin, Germany), followed by a 30 mL saline flush (rate, 3 mL/s). Scans were started at 6 s (arterial phase) after a trigger threshold of 100 HU was reached at the abdominal aorta. Venous phase scanning was performed 35 s after the arterial phase, and delayed phase scanning was performed 120 s after the venous phase. Scanning parameters were set as follows: 200–250 mAs, 120 kVp, and 0.6–0.625 mm detector collimation. CT images were reconstructed using a 3-mm slice thickness/reconstruction interval. Some patients underwent MR examinations as previously described, which was performed 1–2 months after TACE.

All CT imaging was performed using the same multidetector CT system (Brilliance 128, Philips Healthcare, Best, The Netherlands) following to a standardized protocol. Three phase images (conventional, arterial and portal venous) were obtained from each patient. The CT scanning parameters were as the following: tube voltage of 120 kV; slice thickness of 3 mm; beam collimation, 128 × 0.625 mm; and automatic tube current modulation. Contrast-enhanced CT images were obtained after intravenous administration of iohexol (300 mg/mL, Bayer Health Care Pharmaceuticals, Germany) at a rate of 3.0 mL/s via a power injector (1.5 ml/kg), followed by a 20-mL bolus of sodium chloride. The enhanced images were obtained at the arterial phase (30–35 s) and the portal phase (55–60s).

The imaging was conducted using a 320-channel scanner (Aquilion ONE 640; Canon Medical Systems) and a 256-channel scanner (Brilliance 128; Philips Medical Systems). The imaging parameters employed were as follows: tube current ranged from 80 to 230 mA, tube voltage was set at 120 kV, slice thickness was between 1 and 3 mm, field of view (FOV) was 500 mm, and detector pitch spanned 0.75–1.172 mm. Each patient received 80–100 mL of a non-ionic iodinated contrast agent (300 mgI/mL) at a flow rate of 2.5-3.0 mL/s. The average imaging delays stood at 30–40 s for the arterial phase and 65–70 s for the portal venous phase.
To facilitate the training of the segmentation model, a total of 117 arterial phase CT images were manually annotated and employed as the training dataset. To ensure the accuracy and reliability of the manual annotations, we implemented a multi-check method. Each image was independently annotated by two doctors, who would then compare and discuss their annotation results to resolve any discrepancies. Additionally, we employed the Intraclass Correlation Coefficient (ICC) for evaluation (> 0.85). Notably, the annotators remained blinded to the histopathology results during this procedure. The ROI relating to the tumor were manually delineated on each image slice using 3D Slicer (version 4.11) [18 (link)].