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Li S, Fan Z, Guo J, Li D, Chen Z, Zhang X, Wang Y, Li Y, Yang G, Wang X. Compressed sensing 3D T2WI radiomics model: improving diagnostic performance in muscle invasion of bladder cancer. BMC Med Imaging 2024; 24:148. [PMID: 38886638 PMCID: PMC11181529 DOI: 10.1186/s12880-024-01318-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Preoperative discrimination between non-muscle-invasive bladder cancer (NMIBC) and the muscle invasive bladder cancer (MIBC) is a determinant of management. The purpose of this research is to employ radiomics to evaluate the diagnostic value in determining muscle invasiveness of compressed sensing (CS) accelerated 3D T2-weighted-SPACE sequence with high resolution and short acquisition time. METHODS This prospective study involved 108 participants who underwent preoperative 3D-CS-T2-weighted-SPACE, 3D-T2-weighted-SPACE and T2-weighted sequences. The cohort was divided into training and validation cohorts in a 7:3 ratio. In the training cohort, a Rad-score was constructed based on radiomic features selected by intraclass correlation coefficients, pearson correlation coefficient and least absolute shrinkage and selection operator . Multivariate logistic regression was used to develop a nomogram combined radiomics and clinical indices. In the validation cohort, the performances of the models were evaluated by ROC, calibration, and decision curves. RESULTS In the validation cohort, the area under ROC curve of 3D-CS-T2-weighted-SPACE, 3D-T2-weighted-SPACE and T2-weighted models were 0.87(95% confidence interval (CI):0.73-1.00), 0.79(95%CI:0.63-0.96) and 0.77(95%CI:0.60-0.93), respectively. The differences in signal-to-noise ratio and contrast-to-noise ratio between 3D-CS-T2-weighted-SPACE and 3D-T2-weighted-SPACE sequences were not statistically significant(p > 0.05). While the clinical model composed of three clinical indices was 0.74(95%CI:0.55-0.94) and the radiomics-clinical nomogram model was 0.88(95%CI:0.75-1.00). The calibration curves confirmed high goodness of fit, and the decision curve also showed that the radiomics model and combined nomogram model yielded higher net benefits than the clinical model. CONCLUSION The radiomics model based on compressed sensing 3D T2WI sequence, which was acquired within a shorter acquisition time, showed superior diagnostic efficacy in muscle invasion of bladder cancer. Additionally, the nomogram model could enhance the diagnostic performance.
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Affiliation(s)
- Shuo Li
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Zhichang Fan
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Junting Guo
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Ding Li
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Zeke Chen
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Xiaoyue Zhang
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, 030001, Shanxi, P.R. China
| | - Yongfang Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Yan Li
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Guoqiang Yang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China
| | - Xiaochun Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, No.85 Jiefang South Road, Taiyuan, 030001, Shanxi Province, P.R. China.
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Yang G, Bai J, Hao M, Zhang L, Fan Z, Wang X. Enhancing recurrence risk prediction for bladder cancer using multi-sequence MRI radiomics. Insights Imaging 2024; 15:88. [PMID: 38526620 DOI: 10.1186/s13244-024-01662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/04/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE We aimed to develop a radiomics-clinical nomogram using multi-sequence MRI to predict recurrence-free survival (RFS) in bladder cancer (BCa) patients and assess its superiority over clinical models. METHODS A retrospective cohort of 229 BCa patients with preoperative multi-sequence MRI was divided into a training set (n = 160) and a validation set (n = 69). Radiomics features were extracted from T2-weighted images, diffusion-weighted imaging, apparent diffusion coefficient, and dynamic contrast-enhanced images. Effective features were identified using the least absolute shrinkage and selection operator (LASSO) method. Clinical risk factors were determined via univariate and multivariate Cox analysis, leading to the creation of a radiomics-clinical nomogram. Kaplan-Meier analysis and log-rank tests assessed the relationship between radiomics features and RFS. We calculated the net reclassification improvement (NRI) to evaluate the added value of the radiomics signature and used decision curve analysis (DCA) to assess the nomogram's clinical validity. RESULTS Radiomics features significantly correlated with RFS (log-rank p < 0.001) and were independent of clinical factors (p < 0.001). The combined model, incorporating radiomics features and clinical data, demonstrated the best prognostic value, with C-index values of 0.853 in the training set and 0.832 in the validation set. Compared to the clinical model, the radiomics-clinical nomogram exhibited superior calibration and classification (NRI: 0.6768, 95% CI: 0.5549-0.7987, p < 0.001). CONCLUSION The radiomics-clinical nomogram, based on multi-sequence MRI, effectively assesses the BCa recurrence risk. It outperforms both the radiomics model and the clinical model in predicting BCa recurrence risk. CRITICAL RELEVANCE STATEMENT The radiomics-clinical nomogram, utilizing multi-sequence MRI, holds promise for predicting bladder cancer recurrence, enhancing individualized clinical treatment, and performing tumor surveillance. KEY POINTS • Radiomics plays a vital role in predicting bladder cancer recurrence. • Precise prediction of tumor recurrence risk is crucial for clinical management. • MRI-based radiomics models excel in predicting bladder cancer recurrence.
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Affiliation(s)
- Guoqiang Yang
- Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jingjing Bai
- Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Min Hao
- Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lu Zhang
- Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Zhichang Fan
- Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaochun Wang
- Department of Radiology, the First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
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Ye Y, Luo Z, Qiu Z, Cao K, Huang B, Deng L, Zhang W, Liu G, Zou Y, Zhang J, Li J. Radiomics Prediction of Muscle Invasion in Bladder Cancer Using Semi-Automatic Lesion Segmentation of MRI Compared with Manual Segmentation. Bioengineering (Basel) 2023; 10:1355. [PMID: 38135946 PMCID: PMC10740947 DOI: 10.3390/bioengineering10121355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/10/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Conventional radiomics analysis requires the manual segmentation of lesions, which is time-consuming and subjective. This study aimed to assess the feasibility of predicting muscle invasion in bladder cancer (BCa) with radiomics using a semi-automatic lesion segmentation method on T2-weighted images. Cases of non-muscle-invasive BCa (NMIBC) and muscle-invasive BCa (MIBC) were pathologically identified in a training cohort and in internal and external validation cohorts. For bladder tumor segmentation, a deep learning-based semi-automatic model was constructed, while manual segmentation was performed by a radiologist. Semi-automatic and manual segmentation results were respectively used in radiomics analyses to distinguish NMIBC from MIBC. An equivalence test was used to compare the models' performance. The mean Dice similarity coefficients of the semi-automatic segmentation method were 0.836 and 0.801 in the internal and external validation cohorts, respectively. The area under the receiver operating characteristic curve (AUC) were 1.00 (0.991) and 0.892 (0.894) for the semi-automated model (manual) on the internal and external validation cohort, respectively (both p < 0.05). The average total processing time for semi-automatic segmentation was significantly shorter than that for manual segmentation (35 s vs. 92 s, p < 0.001). The BCa radiomics model based on semi-automatic segmentation method had a similar diagnostic performance as that of manual segmentation, while being less time-consuming and requiring fewer manual interventions.
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Affiliation(s)
- Yaojiang Ye
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
| | - Zixin Luo
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Zhengxuan Qiu
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Kangyang Cao
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China; (Z.L.); (Z.Q.); (K.C.); (B.H.)
| | - Lei Deng
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
| | - Weijing Zhang
- Imaging Department, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China;
| | - Guoqing Liu
- College of Physics and Optoelectronic Engineering, Shenzhen University, Shenzhen 518060, China;
| | - Yujian Zou
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
| | - Jian Zhang
- Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518060, China
| | - Jianpeng Li
- Department of Radiology, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan 523059, China; (Y.Y.); (L.D.); (Y.Z.)
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Liu Y, Yin P, Cui J, Sun C, Chen L, Hong N, Li Z. Radiomics analysis based on CT for the prediction of pulmonary metastases in ewing sarcoma. BMC Med Imaging 2023; 23:147. [PMID: 37784073 PMCID: PMC10544364 DOI: 10.1186/s12880-023-01077-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/14/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES This study aimed to develop and validate radiomics models on the basis of computed tomography (CT) and clinical features for the prediction of pulmonary metastases (MT) in patients with Ewing sarcoma (ES) within 2 years after diagnosis. MATERIALS AND METHODS A total of 143 patients with a histopathological diagnosis of ES were enrolled in this study (114 in the training cohort and 29 in the validation cohort). The regions of interest (ROIs) were handcrafted along the boundary of each tumor on the CT and CT-enhanced (CTE) images, and radiomic features were extracted. Six different models were built, including three radiomics models (CT, CTE and ComB models) and three clinical-radiomics models (CT_clinical, CTE_clinical and ComB_clinical models). The area under the receiver operating characteristic curve (AUC), and accuracy were calculated to evaluate the different models, and DeLong test was used to compare the AUCs of the models. RESULTS Among the clinical risk factors, the therapeutic method had significant differences between the MT and non-MT groups (P<0.01). The six models performed well in predicting pulmonary metastases in patients with ES, and the ComB model (AUC: 0.866/0.852 in training/validation cohort) achieved the highest AUC among the six models. However, no statistically significant difference was observed between the AUC of the models. CONCLUSIONS In patients with ES, clinical-radiomics model created using radiomics signature and clinical features provided favorable ability and accuracy for pulmonary metastases prediction.
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Affiliation(s)
- Ying Liu
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing, 100044, People's Republic of China
| | - Ping Yin
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing, 100044, People's Republic of China
| | - Jingjing Cui
- United Imaging Intelligence (Beijing) Co., Ltd, Yongteng North Road, Haidian District, Beijing, 100094, People's Republic of China
| | - Chao Sun
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing, 100044, People's Republic of China
| | - Lei Chen
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing, 100044, People's Republic of China
| | - Nan Hong
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing, 100044, People's Republic of China.
| | - Zhentao Li
- Department of Radiology, Peking University People's Hospital, 11 Xizhimen Nandajie, Xicheng District, Beijing, 100044, People's Republic of China.
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Grobet-Jeandin E, Lenfant L, Mir C, Giannarini G, Alcaraz A, Albersen M, Breda A, Briganti A, Rouprêt M, Seisen T. A Systematic Review of Oncological Outcomes Associated with Bladder-sparing Strategies in Patients Achieving Complete Clinical Response to Initial Systemic Treatment for Localized Muscle-invasive Bladder Cancer. Eur Urol Oncol 2023; 6:251-262. [PMID: 36906510 DOI: 10.1016/j.euo.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/14/2022] [Accepted: 02/08/2023] [Indexed: 03/13/2023]
Abstract
CONTEXT Bladder-sparing strategies (BSSs) have been proposed for the treatment of muscle-invasive bladder cancer (MIBC) patients achieving clinical complete response (cCR) to initial systemic treatment to avoid toxicity related to radical cystectomy. OBJECTIVE To systematically review the current literature evaluating oncological outcomes of BSSs in patients achieving cCR to initial systemic treatment for localized MIBC. EVIDENCE ACQUISITION A computerized bibliographic search of the Medline, Embase, and Cochrane databases was performed for all studies reporting oncological outcomes of MIBC patients undergoing either surveillance or radiation therapy after achieving cCR to initial systemic treatment. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we identified 23 noncomparative prospective or retrospective studies published between 1990 and 2021. The mean bladder and metastatic recurrence rates (range) as well as the mean bladder preservation rate (BPR; range) were calculated, and overall survival (OS) was extracted from included reports. EVIDENCE SYNTHESIS Overall, 16 and seven studies evaluated surveillance (n = 610) and radiation therapy (n = 175) in MIBC patients achieving cCR to initial systemic treatment, respectively. With regard to surveillance, the median follow-up ranged from 10 to 120 mo, with a mean bladder recurrence rate of 43% (0-71%), including 65% of non-muscle-invasive bladder cancer (NMIBC) and 35% of MIBC recurrences. The mean BPR was 73% (49-100%). The mean metastatic recurrence rate was 9% (0-27%), while 5-yr OS rates ranged from 64% to 89%. With regard to radiation therapy, the median follow-up ranged from 12 to 60 mo, with a mean bladder recurrence rate of 15% (0-29%), including 24% of NMIBC, 43% of MIBC, and 33% of unspecified recurrences. The mean BPR was 74% (71-100%). The mean metastatic recurrence rate was 17% (0-22%), while the 4-yr OS rate was 79%. CONCLUSIONS Our systematic review showed that only low-level evidence supports the effectiveness of BSSs in selected patients achieving cCR to initial systemic treatment for localized MIBC. These preliminary findings highlight the need for further prospective comparative research to demonstrate its efficacy. PATIENT SUMMARY We reviewed studies evaluating bladder-sparing strategies in patients achieving complete clinical response to initial systemic treatment for localized muscle-invasive bladder cancer. Based on low-level evidence, we observed that selected patients could benefit from surveillance or radiation therapy in this setting, but prospective comparative research is requested to confirm their efficacy.
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Affiliation(s)
- Elisabeth Grobet-Jeandin
- Department of Urology, Pitié Salpêtrière Hospital, APHP, GRC 5, Predictive Onco-Urology, Sorbonne University, F-75013, Paris, France; Division of Urology, Geneva University Hospitals, Geneva, Switzerland
| | - Louis Lenfant
- Department of Urology, Pitié Salpêtrière Hospital, APHP, GRC 5, Predictive Onco-Urology, Sorbonne University, F-75013, Paris, France
| | - Carmen Mir
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Gianluca Giannarini
- Urology Unit, Academic Medical Centre "Santa Maria della Misericordia", Udine, Italy
| | - Antonio Alcaraz
- Urology Department, Hospital Clínic de Barcelona, Barcelona, Catalunya, Spain
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium; Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Morgan Rouprêt
- Department of Urology, Pitié Salpêtrière Hospital, APHP, GRC 5, Predictive Onco-Urology, Sorbonne University, F-75013, Paris, France
| | - Thomas Seisen
- Department of Urology, Pitié Salpêtrière Hospital, APHP, GRC 5, Predictive Onco-Urology, Sorbonne University, F-75013, Paris, France.
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Radiomics Signature Using Manual Versus Automated Segmentation for Lymph Node Staging of Bladder Cancer. Eur Urol Focus 2023; 9:145-153. [PMID: 36115774 DOI: 10.1016/j.euf.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/26/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Bladder cancer (BC) treatment algorithms depend on accurate tumor staging. To date, computed tomography (CT) is recommended for assessment of lymph node (LN) metastatic spread in muscle-invasive and high-risk BC. However, the diagnostic efficacy of radiologist-evaluated CT imaging studies is limited. OBJECTIVE To evaluate the performance of quantitative radiomics signatures for detection of LN metastases in BC. DESIGN, SETTING, AND PARTICIPANTS Of 1354 patients with BC who underwent radical cystectomy (RC) with lymphadenectomy who were screened, 391 with pathological nodal staging (pN0: n = 297; pN+: n = 94) were included and randomized into training (n = 274) and test (n = 117) cohorts. Pelvic LNs were segmented manually and automatically. A total of 1004 radiomics features were extracted from each LN and a machine learning model was trained to assess pN status using histopathology labels as the ground truth. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Radiologist assessment was compared to radiomics-based analysis using manual and automated LN segmentations for detection of LN metastases in BC. Statistical analysis was performed using the receiver operating characteristics curve method and evaluated in terms of sensitivity, specificity, and area under the curve (AUC). RESULTS AND LIMITATIONS In total, 1845 LNs were manually segmented. Automated segmentation correctly located 361/557 LNs in the test cohort. Manual and automatic masks achieved an AUC of 0.80 (95% confidence interval [CI] 0.69-0.91; p = 0.64) and 0.70 (95% CI: 0.58-0.82; p = 0.17), respectively, in the test cohort compared to radiologist assessment, with an AUC of 0.78 (95% CI 0.67-0.89). A combined model of a manually segmented radiomics signature and radiologist assessment reached an AUC of 0.81 (95% CI 0.71-0.92; p = 0.63). CONCLUSIONS A radiomics signature allowed discrimination of nodal status with high diagnostic accuracy. The model based on manual LN segmentation outperformed the fully automated approach. PATIENT SUMMARY For patients with bladder cancer, evaluation of computed tomography (CT) scans before surgery using a computer-based method for image analysis, called radiomics, may help in standardizing and improving the accuracy of assessment of lymph nodes. This could be a valuable tool for optimizing treatment options.
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Miyagi H, Kwenda E, Ramnaraign BH, Chatzkel JA, Brisbane WG, O’Malley P, Crispen PL. Predicting Complete Response to Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer. Cancers (Basel) 2022; 15:168. [PMID: 36612164 PMCID: PMC9817944 DOI: 10.3390/cancers15010168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022] Open
Abstract
Muscle-invasive bladder cancer is a life-threatening disease best managed with multimodal therapy. Neoadjuvant chemotherapy prior to cystectomy significantly improves survival with the greatest benefit noted in patients with a complete pathologic response noted at cystectomy. While radical cystectomy is currently an important part of the treatment plan, surgical morbidity remains high. Accurate prediction of complete responses to chemotherapy would enable avoiding the morbidity of radical cystectomy. Multiple clinical, pathologic, molecular, and radiographic predictors have been evaluated. Clinical and standard pathologic findings have not been found to be accurate predictors of complete response. To date, tumor genomic findings have been the most promising and have led to multiple clinical trials to evaluate if bladder preservation is possible in select patients. Radiomics has shown initial promise with larger validation series needed. These predictors can be further characterized as treatment specific and non-treatment specific. With the potential changing landscape of neoadjuvant therapy prior to radical cystectomy and the limitations of individual predictors of a complete response, a panel of several biomarkers may enhance patient selection for bladder preservation. The aim of this review is to summarize predictors of complete response to neoadjuvant chemotherapy.
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Affiliation(s)
- Hiroko Miyagi
- Department of Urology, University of Florida, Gainesville, FL 32611, USA
| | - Elizabeth Kwenda
- Department of Urology, University of Florida, Gainesville, FL 32611, USA
| | | | | | - Wayne G. Brisbane
- Department of Urology, University of Florida, Gainesville, FL 32611, USA
| | - Padraic O’Malley
- Department of Urology, University of Florida, Gainesville, FL 32611, USA
| | - Paul L. Crispen
- Department of Urology, University of Florida, Gainesville, FL 32611, USA
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Woźnicki P, Laqua FC, Messmer K, Kunz WG, Stief C, Nörenberg D, Schreier A, Wójcik J, Ruebenthaler J, Ingrisch M, Ricke J, Buchner A, Schulz GB, Gresser E. Radiomics for the Prediction of Overall Survival in Patients with Bladder Cancer Prior to Radical Cystectomy. Cancers (Basel) 2022; 14:4449. [PMID: 36139609 PMCID: PMC9497387 DOI: 10.3390/cancers14184449] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: To evaluate radiomics features as well as a combined model with clinical parameters for predicting overall survival in patients with bladder cancer (BCa). (2) Methods: This retrospective study included 301 BCa patients who received radical cystectomy (RC) and pelvic lymphadenectomy. Radiomics features were extracted from the regions of the primary tumor and pelvic lymph nodes as well as the peritumoral regions in preoperative CT scans. Cross-validation was performed in the training cohort, and a Cox regression model with an elastic net penalty was trained using radiomics features and clinical parameters. The models were evaluated with the time-dependent area under the ROC curve (AUC), Brier score and calibration curves. (3) Results: The median follow-up time was 56 months (95% CI: 48−74 months). In the follow-up period from 1 to 7 years after RC, radiomics models achieved comparable predictive performance to validated clinical parameters with an integrated AUC of 0.771 (95% CI: 0.657−0.869) compared to an integrated AUC of 0.761 (95% CI: 0.617−0.874) for the prediction of overall survival (p = 0.98). A combined clinical and radiomics model stratified patients into high-risk and low-risk groups with significantly different overall survival (p < 0.001). (4) Conclusions: Radiomics features based on preoperative CT scans have prognostic value in predicting overall survival before RC. Therefore, radiomics may guide early clinical decision-making.
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Affiliation(s)
- Piotr Woźnicki
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg-Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Fabian Christopher Laqua
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg-Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Katharina Messmer
- Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Wolfgang Gerhard Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Christian Stief
- Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Dominik Nörenberg
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim-Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany
| | - Andrea Schreier
- Department of Otolaryngology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Jan Wójcik
- Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02091 Warsaw, Poland
| | - Johannes Ruebenthaler
- Department of Radiology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Michael Ingrisch
- Department of Radiology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Alexander Buchner
- Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Gerald Bastian Schulz
- Department of Urology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
| | - Eva Gresser
- Department of Radiology, University Hospital, LMU Munich, Munich-Marchioninistr. 15, 81377 Munich, Germany
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Sarafidis M, Lambrou GI, Zoumpourlis V, Koutsouris D. An Integrated Bioinformatics Analysis towards the Identification of Diagnostic, Prognostic, and Predictive Key Biomarkers for Urinary Bladder Cancer. Cancers (Basel) 2022; 14:cancers14143358. [PMID: 35884419 PMCID: PMC9319344 DOI: 10.3390/cancers14143358] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Bladder cancer is evidently a challenge as far as its prognosis and treatment are concerned. The investigation of potential biomarkers and therapeutic targets is indispensable and still in progress. Most studies attempt to identify differential signatures between distinct molecular tumor subtypes. Therefore, keeping in mind the heterogeneity of urinary bladder tumors, we attempted to identify a consensus gene-related signature between the common expression profile of bladder cancer and control samples. In the quest for substantive features, we were able to identify key hub genes, whose signatures could hold diagnostic, prognostic, or therapeutic significance, but, primarily, could contribute to a better understanding of urinary bladder cancer biology. Abstract Bladder cancer (BCa) is one of the most prevalent cancers worldwide and accounts for high morbidity and mortality. This study intended to elucidate potential key biomarkers related to the occurrence, development, and prognosis of BCa through an integrated bioinformatics analysis. In this context, a systematic meta-analysis, integrating 18 microarray gene expression datasets from the GEO repository into a merged meta-dataset, identified 815 robust differentially expressed genes (DEGs). The key hub genes resulted from DEG-based protein–protein interaction and weighted gene co-expression network analyses were screened for their differential expression in urine and blood plasma samples of BCa patients. Subsequently, they were tested for their prognostic value, and a three-gene signature model, including COL3A1, FOXM1, and PLK4, was built. In addition, they were tested for their predictive value regarding muscle-invasive BCa patients’ response to neoadjuvant chemotherapy. A six-gene signature model, including ANXA5, CD44, NCAM1, SPP1, CDCA8, and KIF14, was developed. In conclusion, this study identified nine key biomarker genes, namely ANXA5, CDT1, COL3A1, SPP1, VEGFA, CDCA8, HJURP, TOP2A, and COL6A1, which were differentially expressed in urine or blood of BCa patients, held a prognostic or predictive value, and were immunohistochemically validated. These biomarkers may be of significance as prognostic and therapeutic targets for BCa.
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Affiliation(s)
- Michail Sarafidis
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, 9 Iroon Polytechniou Str., 15780 Athens, Greece;
- Correspondence: ; Tel.: +30-210-772-2430
| | - George I. Lambrou
- Choremeio Research Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens, 8 Thivon & Levadeias Str., 11527 Athens, Greece;
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, 8 Thivon & Levadeias Str., 11527 Athens, Greece
| | - Vassilis Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 48 Vas. Konstantinou Ave., 11635 Athens, Greece;
| | - Dimitrios Koutsouris
- Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, 9 Iroon Polytechniou Str., 15780 Athens, Greece;
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10
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Xu L, Yang C, Zhang F, Cheng X, Wei Y, Fan S, Liu M, He X, Deng J, Xie T, Wang X, Liu M, Song B. Deep Learning Using CT Images to Grade Clear Cell Renal Cell Carcinoma: Development and Validation of a Prediction Model. Cancers (Basel) 2022; 14:cancers14112574. [PMID: 35681555 PMCID: PMC9179576 DOI: 10.3390/cancers14112574] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Clear cell renal cell carcinoma (ccRCC) pathologic grade identification is essential to both monitoring patients’ conditions and constructing individualized subsequent treatment strategies. However, biopsies are typically used to obtain the pathological grade, entailing tremendous physical and mental suffering as well as heavy economic burden, not to mention the increased risk of complications. Our study explores a new way to provide grade assessment of ccRCC on the basis of the individual’s appearance on CT images. A deep learning (DL) method that includes self-supervised learning is constructed to identify patients with high grade for ccRCC. We confirmed that our grading network can accurately differentiate between different grades of CT scans of ccRCC patients using a cohort of 706 patients from West China Hospital. The promising diagnostic performance indicates that our DL framework is an effective, non-invasive and labor-saving method for decoding CT images, offering a valuable means for ccRCC grade stratification and individualized patient treatment. Abstract This retrospective study aimed to develop and validate deep-learning-based models for grading clear cell renal cell carcinoma (ccRCC) patients. A cohort enrolling 706 patients (n = 706) with pathologically verified ccRCC was used in this study. A temporal split was applied to verify our models: the first 83.9% of the cases (years 2010–2017) for development and the last 16.1% (year 2018–2019) for validation (development cohort: n = 592; validation cohort: n = 114). Here, we demonstrated a deep learning(DL) framework initialized by a self-supervised pre-training method, developed with the addition of mixed loss strategy and sample reweighting to identify patients with high grade for ccRCC. Four types of DL networks were developed separately and further combined with different weights for better prediction. The single DL model achieved up to an area under curve (AUC) of 0.864 in the validation cohort, while the ensembled model yielded the best predictive performance with an AUC of 0.882. These findings confirms that our DL approach performs either favorably or comparably in terms of grade assessment of ccRCC with biopsies whilst enjoying the non-invasive and labor-saving property.
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Affiliation(s)
- Lifeng Xu
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou 324000, China; (L.X.); (F.Z.)
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
| | - Chun Yang
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Feng Zhang
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou 324000, China; (L.X.); (F.Z.)
| | - Xuan Cheng
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Yi Wei
- West China Hospital, Sichuan University, Chengdu 610000, China;
| | - Shixiao Fan
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Minghui Liu
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Xiaopeng He
- West China Hospital, Sichuan University, Chengdu 610000, China;
- Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
- Correspondence: (X.H.); (B.S.)
| | - Jiali Deng
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Tianshu Xie
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Xiaomin Wang
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Ming Liu
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou 324000, China; (C.Y.); (X.C.); (S.F.); (M.L.); (J.D.); (T.X.); (X.W.); (M.L.)
- University of Electronic Science and Technology of China, Chengdu 610000, China
| | - Bin Song
- West China Hospital, Sichuan University, Chengdu 610000, China;
- Correspondence: (X.H.); (B.S.)
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