Abstract: Objective To investigate the efficacy of enhanced CT texture parameters in predicting poor prognosis after interventional therapy for hepatitis B associated hepatocellular carcinoma (HCC). Methods A total of 69 patients diagnosed with hepatitis B-related HCC and admitted to our hospital between October 2020 and October 2022 were included in the study. The patients underwent enhanced CT scans before treatment and were then divided into two groups based on the efficacy of hepatic artery chemoembolization (TACE) for hepatocellular carcinoma: a poor prognosis group consisting of 14 patients and a good prognosis group consisting of 55 patients. Comparative analysis was conducted on baseline data and enhanced CT texture parameter levels between the two groups. The predictive value of various indicators in determining poor prognosis was evaluated through ROC curves, and risk factors associated with poor prognosis in HCC patients after TACE treatment were identified. Results No significant disparities were found in terms of gender, age, BMI, tumor diameter, proportion of smokers, and kurtosis between the two groups (P>0.05). However, the poor prognosis group exhibited notably higher values in terms of proportion, skewness, entropy and mean value of portal vein metastasis (78.57 %, 1.38±0.39, 2.29±0.41, 88.65±15.72) compared to those in the good prognosis group (38.18 %, 0.80±0.26, 1.77±0.35, 66.94±11.07). Additionally, the energy level [(1.71±0.48) ×10⁶] was significantly lower in the poor prognosis group in comparison to the good prognosis group [(5.14±1.35) ×10⁶] (P<0.05). The ROC analysis revealed that the areas under the curve of skewness, energy, entropy, and mean value in predicting poor prognosis of HCC patients were 0.884, 0.825, 0.795 and 0.864, respectively, all with statistical significance (P<0.05). Logistic regression analysis highlighted portal vein metastasis, skewness ≥ 1.020, and energy ≤ 2.415 ×10⁶, entropy value ≥ 2.265, and average value ≥ 80.495 as risk factors for poor prognosis in HCC patients (P<0.05). Conclusion The texture parameters of portal vein metastasis and enhanced CT, including skewness, energy, entropy and average value, have been identified as potential prognostic predictors for poor prognosis in HCC patients after TACE treatment. It is essential to consider these indicators before treatment and take appropriate measures to improve patient prognosis.

Key words: Hepatocellular carcinoma, Enhanced CT, Interventional therapy, Texture parameter, Efficacy evaluation