The Predictive Performance of Tumor Morphological Features on MRI Combined With Serum CA19-9 for the Efficacy of TACE Treatment in Patients With Primary Liver Cancer

AIM: To explore the predictive performance of magnetic resonance imaging (MRI) combined with serum carbohydrate antigen 19-9 (CA19-9) for the efficacy of transarterial chemoembolization (TACE) treatment in patients with primary liver cancer. METHODS: In this retrospective study, a total of 174 patients with primary liver cancer who underwent TACE treatment at Hangzhou Xixi Hospital between January 2022 and January 2025 were selected as the study subjects. The patients were divided into an effective group and an ineffective group according to the treatment efficacy at 3 months postoperatively, and the clinical data of the two groups were compared. Multifactorial logistic regression analysis was conducted to identify factors affecting patient efficacy, and a predictive model was constructed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of MRI combined with serum CA19-9 and the model. RESULTS: Among the 174 patients, 50 cases achieved complete remission (CR) (28.74%), 29 cases attained partial remission (PR) (16.67%), 58 cases had stable disease (SD) (33.33%), and 37 cases experienced disease progression (PD) (21.26%). The results of multifactorial logistic regression analysis showed that low tumor differentiation, continuous multi-nodular tumor margins, incomplete tumor capsule, higher ALT levels, and high CA19-9 were risk factors for compromised efficacy of TACE treatment in patients with primary liver cancer (p < 0.05), while tumor tissue necrosis was a protective factor (p = 0.001). The area under the curves (AUCs) of MRI, CA19-9, MRI combined with CA19-9, and the model were 0.883, 0.772, 0.904, and 0.958, respectively; the sensitivities were 79.84%, 70.18%, 86.95%, and 89.96%, respectively; and the specificities were 82.69%, 67.88%, 84.02%, and 91.05%, respectively. CONCLUSIONS: MRI demonstrates promising utility in predicting the efficacy of TACE treatment in patients with primary liver cancer, with its predictive performance enhanced by the combination with serum CA19-9.