Primary liver cancer is a commonly diagnosed cancer and accurate diagnosis is crucial for treatment planning. To differentiate between malignant and benign liver tumors, contrast-enhanced MRI is typically used as it provides information over multiple contrast phases. However, diagnosis based on MRI is challenging. In this study, automatic classification is used to distinguish common primary liver tumors.

Imaging data from 102 patients with malignant (hepatocellular carcinoma) and benign (focal nodular hyperplasia and hepatocellular adenoma) primary liver tumors was used for binary classification through radiomics and deep learning approaches. The radiomics method was applied with the use of the open-source toolbox WORC. The deep learning model was based on the ResNet-10 architecture. The data input consisted of individual and combined phases of contrast-enhanced T1-weighted and T2-weighted MRI.

The highest performance values were found for the radiomics approach that combined the precontrast, arterial, portal venous, and delayed contrast phases together with T2-weighted MRI, with an AUC of 0.92. The deep learning model scored an AUC of 0.83 with this data input, however substantial overfitting occurred due to the limited sample size.

In conclusion, the radiomics classifiers based on combined contrast-enhanced T1-weighted and T2-weighted MRI can differentiate malignant from benign primary liver tumors with limited data samples. The classification task is too complex with the given data when using a ResNet-10 model and should be applied to an extended dataset.