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Journal of Hepatology
Article . 2022 . Peer-reviewed
License: Elsevier TDM
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An artificial intelligence model to predict hepatocellular carcinoma risk in Korean and Caucasian patients with chronic hepatitis B

Authors: Maria Buti; Pietro Lampertico; Young-Suk Lim; Jeong Hoon Lee; George V. Papatheodoridis; George N. Dalekos; Soo-Young Park; +31 Authors

An artificial intelligence model to predict hepatocellular carcinoma risk in Korean and Caucasian patients with chronic hepatitis B

Abstract

Several models have recently been developed to predict risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Our aims were to develop and validate an artificial intelligence-assisted prediction model of HCC risk.Using a gradient-boosting machine (GBM) algorithm, a model was developed using 6,051 patients with CHB who received entecavir or tenofovir therapy from 4 hospitals in Korea. Two external validation cohorts were independently established: Korean (5,817 patients from 14 Korean centers) and Caucasian (1,640 from 11 Western centers) PAGE-B cohorts. The primary outcome was HCC development.In the derivation cohort and the 2 validation cohorts, cirrhosis was present in 26.9%-50.2% of patients at baseline. A model using 10 parameters at baseline was derived and showed good predictive performance (c-index 0.79). This model showed significantly better discrimination than previous models (PAGE-B, modified PAGE-B, REACH-B, and CU-HCC) in both the Korean (c-index 0.79 vs. 0.64-0.74; all p <0.001) and Caucasian validation cohorts (c-index 0.81 vs. 0.57-0.79; all p <0.05 except modified PAGE-B, p = 0.42). A calibration plot showed a satisfactory calibration function. When the patients were grouped into 4 risk groups, the minimal-risk group (11.2% of the Korean cohort and 8.8% of the Caucasian cohort) had a less than 0.5% risk of HCC during 8 years of follow-up.This GBM-based model provides the best predictive power for HCC risk in Korean and Caucasian patients with CHB treated with entecavir or tenofovir.Risk scores have been developed to predict the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B. We developed and validated a new risk prediction model using machine learning algorithms in 13,508 antiviral-treated patients with chronic hepatitis B. Our new model, based on 10 common baseline characteristics, demonstrated superior performance in risk stratification compared with previous risk scores. This model also identified a group of patients at minimal risk of developing HCC, who could be indicated for less intensive HCC surveillance.

Keywords

Male, Chronic / complications*, HBV; HCC; antiviral treatment; chronic hepatitis B; deep neural networking; liver cancer, Artificial Intelligence / statistics & numerical data, antiviral treatment, Tenofovir / therapeutic use, White People / statistics & numerical data, Liver Neoplasms / physiopathology, Guanine / therapeutic use, Cohort Studies, Computer Simulation / statistics & numerical data, HBV, HCC, Liver Neoplasms, Liver Neoplasms / complications, Middle Aged, Hepatocellular / etiology, Hepatitis B, Antiviral Agents / pharmacology, Female, Hepatocellular / physiopathology*, White People / ethnology, Adult, Computer Simulation / standards, Carcinoma, Hepatocellular, Guanine, Antiviral Agents / therapeutic use, deep neural networking, 610, Antiviral Agents, White People, liver cancer, Hepatitis B, Chronic, Asian People, Republic of Korea / ethnology, Artificial Intelligence, Republic of Korea, Humans, chronic hepatitis B, Computer Simulation, Tenofovir, Tenofovir / pharmacology, Chronic / physiopathology, Carcinoma, Artificial Intelligence / standards*, Guanine / analogs & derivatives, Asian People / ethnology, Asian People / statistics & numerical data, Guanine / pharmacology, Follow-Up Studies

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
109
Top 1%
Top 10%
Top 1%
Green