Abstract: Objective To predict microvascular invasion (MVI) in hepatocellular carcinoma (HCC) using a model based on multi-phase dynamic-enhanced CT (DCE-CT) radiomics feature and hierarchical fusion of multiple classifiers. Methods We retrospectively collected preoperative DCE- CT images from 111 patients with pathologically confirmed HCC in Guangzhou First People's Hospital between January, 2016 and April, 2020. The volume of interest was outlined in the early arterial phase, late arterial phase, portal venous phase and equilibrium phase, and radiomics features of these 4 phases were extracted. Seven classifiers based on different algorithms were trained using the filtered feature subsets to obtain multiple base classifiers under each phase. According to the hierarchical fusion strategy, a multi-criteria decision-making-based weight assignment algorithm was used for fusing each base classifier under the same phase with the model after extracting the phase information to obtain the prediction model. The proposed model was evaluated using a 5-fold cross-validation and assessed for area under the ROC curve (AUC), accuracy, sensitivity, and specificity. The prediction model was also compared with the fusion models using a single phase or multiple phases, models based on a single phase with a single classifier, models with different base classifier diversities, and 8 classifier models based on other ensemble methods. Results The experimental results showed that the performance of the proposed model for predicting HCCMVI was optimal after incorporating the 4 phases and 7 classifiers, with AUC, accuracy, sensitivity, and specificity of 0.828, 0.766, 0.877, and 0.648, respectively. Comparative experiments showed that this prediction model outperformed the models based on a single phase with a single classifier and other ensemble models. Conclusion The proposed prediction model is effective for predicting MVI in HCC with superior performance to other models.

Key words: hepatocellular carcinoma; microvascular invasion; dynamic enhanced computed tomography; multi classifier; multi-criteria decision making