After combining these three imaging features with AFP level, the CR model showed good and stable predictive performance of Ki-67, with an AUC of 0.836 (95% CI: 0.765–0.907), 0.805 (95% CI: 0.683–0.926), and 0.805 (95% CI: 0.657–0.953) in training, testing, and external validation sets, respectively, helping identify high-risk HCC groups. This evidence concerns the gene MKI67 and hepatocellular carcinoma.