1
|
Fan W, Sun W, Xu MZ, Pan JJ, Man FY. Diagnosis of benign and malignant nodules with a radiomics model integrating features from nodules and mammary regions on DCE-MRI. Front Oncol 2024; 14:1307907. [PMID: 38450180 PMCID: PMC10915177 DOI: 10.3389/fonc.2024.1307907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024] Open
Abstract
Objectives To establish a radiomics model for distinguishing between the benign and malignant mammary gland nodules via combining the features from nodule and mammary regions on DCE-MRI. Methods In this retrospective study, a total of 103 cases with mammary gland nodules (malignant/benign = 80/23) underwent DCE-MRI, and was confirmed by biopsy pathology. Features were extracted from both nodule region and mammary region on DCE-MRI. Three SVM classifiers were built for diagnosis of benign and malignant nodules as follows: the model with the features only from nodule region (N model), with the features only from mammary region (M model) and the model combining the features from nodule region and mammary region (NM model). The performance of models was evaluated with the area under the curve of receiver operating characteristic (AUC). Results One radiomic features is selected from nodule region and 3 radiomic features is selected from mammary region. Compared with N or M model, NM model exhibited the best performance with an AUC of 0.756. Conclusions Compared with the model only using the features from nodule or mammary region, the radiomics-based model combining the features from nodule and mammary region outperformed in the diagnosis of benign and malignant nodules.
Collapse
Affiliation(s)
- Wei Fan
- Department of Radiology, Rocket Force Characteristic Medical Center of the Chinese People's Liberation Army, Beijing, China
| | - Wei Sun
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Ze Xu
- Postgraduate Training Base of Jinzhou Medical University, Rocket Force Characteristic Medical Center of the Chinese People’s Liberation Army, Beijing, China
| | - Jing Jing Pan
- Department of Radiology, Rocket Force Characteristic Medical Center of the Chinese People's Liberation Army, Beijing, China
| | - Feng Yuan Man
- Department of Radiology, Rocket Force Characteristic Medical Center of the Chinese People's Liberation Army, Beijing, China
| |
Collapse
|
2
|
Fusco R, Granata V, Simonetti I, Setola SV, Iasevoli MAD, Tovecci F, Lamanna CMP, Izzo F, Pecori B, Petrillo A. An Informative Review of Radiomics Studies on Cancer Imaging: The Main Findings, Challenges and Limitations of the Methodologies. Curr Oncol 2024; 31:403-424. [PMID: 38248112 PMCID: PMC10814313 DOI: 10.3390/curroncol31010027] [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: 11/17/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
The aim of this informative review was to investigate the application of radiomics in cancer imaging and to summarize the results of recent studies to support oncological imaging with particular attention to breast cancer, rectal cancer and primitive and secondary liver cancer. This review also aims to provide the main findings, challenges and limitations of the current methodologies. Clinical studies published in the last four years (2019-2022) were included in this review. Among the 19 studies analyzed, none assessed the differences between scanners and vendor-dependent characteristics, collected images of individuals at additional points in time, performed calibration statistics, represented a prospective study performed and registered in a study database, conducted a cost-effectiveness analysis, reported on the cost-effectiveness of the clinical application, or performed multivariable analysis with also non-radiomics features. Seven studies reached a high radiomic quality score (RQS), and seventeen earned additional points by using validation steps considering two datasets from two distinct institutes and open science and data domains (radiomics features calculated on a set of representative ROIs are open source). The potential of radiomics is increasingly establishing itself, even if there are still several aspects to be evaluated before the passage of radiomics into routine clinical practice. There are several challenges, including the need for standardization across all stages of the workflow and the potential for cross-site validation using real-world heterogeneous datasets. Moreover, multiple centers and prospective radiomics studies with more samples that add inter-scanner differences and vendor-dependent characteristics will be needed in the future, as well as the collecting of images of individuals at additional time points, the reporting of calibration statistics and the performing of prospective studies registered in a study database.
Collapse
Affiliation(s)
- Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Naples, Italy;
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| | - Igino Simonetti
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| | - Sergio Venanzio Setola
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| | - Maria Assunta Daniela Iasevoli
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| | - Filippo Tovecci
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| | - Ciro Michele Paolo Lamanna
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| | - Francesco Izzo
- Division of Epatobiliary Surgical Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy;
| | - Biagio Pecori
- Division of Radiation Protection and Innovative Technology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy;
| | - Antonella Petrillo
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli, 80131 Naples, Italy (S.V.S.); (M.A.D.I.); (F.T.); (C.M.P.L.); (A.P.)
| |
Collapse
|
3
|
Leung VWS, Ng CKC, Lam SK, Wong PT, Ng KY, Tam CH, Lee TC, Chow KC, Chow YK, Tam VCW, Lee SWY, Lim FMY, Wu JQ, Cai J. Computed Tomography-Based Radiomics for Long-Term Prognostication of High-Risk Localized Prostate Cancer Patients Received Whole Pelvic Radiotherapy. J Pers Med 2023; 13:1643. [PMID: 38138870 PMCID: PMC10744672 DOI: 10.3390/jpm13121643] [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: 11/03/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Given the high death rate caused by high-risk prostate cancer (PCa) (>40%) and the reliability issues associated with traditional prognostic markers, the purpose of this study is to investigate planning computed tomography (pCT)-based radiomics for the long-term prognostication of high-risk localized PCa patients who received whole pelvic radiotherapy (WPRT). This is a retrospective study with methods based on best practice procedures for radiomics research. Sixty-four patients were selected and randomly assigned to training (n = 45) and testing (n = 19) cohorts for radiomics model development with five major steps: pCT image acquisition using a Philips Big Bore CT simulator; multiple manual segmentations of clinical target volume for the prostate (CTVprostate) on the pCT images; feature extraction from the CTVprostate using PyRadiomics; feature selection for overfitting avoidance; and model development with three-fold cross-validation. The radiomics model and signature performances were evaluated based on the area under the receiver operating characteristic curve (AUC) as well as accuracy, sensitivity and specificity. This study's results show that our pCT-based radiomics model was able to predict the six-year progression-free survival of the high-risk localized PCa patients who received the WPRT with highly consistent performances (mean AUC: 0.76 (training) and 0.71 (testing)). These are comparable to findings of other similar studies including those using magnetic resonance imaging (MRI)-based radiomics. The accuracy, sensitivity and specificity of our radiomics signature that consisted of two texture features were 0.778, 0.833 and 0.556 (training) and 0.842, 0.867 and 0.750 (testing), respectively. Since CT is more readily available than MRI and is the standard-of-care modality for PCa WPRT planning, pCT-based radiomics could be used as a routine non-invasive approach to the prognostic prediction of WPRT treatment outcomes in high-risk localized PCa.
Collapse
Affiliation(s)
- Vincent W. S. Leung
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Curtise K. C. Ng
- Curtin Medical School, Curtin University, GPO Box U1987, Perth, WA 6845, Australia;
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia
| | - Sai-Kit Lam
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China;
| | - Po-Tsz Wong
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Ka-Yan Ng
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Cheuk-Hong Tam
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Tsz-Ching Lee
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Kin-Chun Chow
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Yan-Kate Chow
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Victor C. W. Tam
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Shara W. Y. Lee
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| | - Fiona M. Y. Lim
- Department of Oncology, Princess Margaret Hospital, Hong Kong SAR, China;
| | - Jackie Q. Wu
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27708, USA;
| | - Jing Cai
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; (P.-T.W.); (V.C.W.T.); (S.W.Y.L.); (J.C.)
| |
Collapse
|
4
|
Lu D, Yan Y, Jiang M, Sun S, Jiang H, Lu Y, Zhang W, Zhou X. Predictive value of radiomics-based machine learning for the disease-free survival in breast cancer: a systematic review and meta-analysis. Front Oncol 2023; 13:1173090. [PMID: 37664048 PMCID: PMC10469000 DOI: 10.3389/fonc.2023.1173090] [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: 02/24/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose This study summarized the previously-published studies regarding the use of radiomics-based predictive models for the identification of breast cancer-associated prognostic factors, which can help clinical decision-making and follow-up strategy. Materials and methods This study has been pre-registered on PROSPERO. PubMed, Embase, Cochrane Library, and Web of Science were searched, from inception to April 23, 2022, for studies that used radiomics for prognostic prediction of breast cancer patients. Then the search was updated on July 18, 2023. Quality assessment was conducted using the Radiomics Quality Score, and meta-analysis was performed using R software. Results A total of 975 articles were retrieved, and 13 studies were included, involving 5014 participants and 35 prognostic models. Among the models, 20 models were radiomics-based and the other 15 were based on clinical or pathological information. The primary outcome was Disease-free Survival (DFS). The retrieved studies were screened using LASSO, and Cox Regression was applied for modeling. The mean RQS was 18. The c-index of radiomics-based models for DFS prediction was 0.763 (95%CI 0.718-0.810) in the training set and 0.702 (95%CI 0.637-0.774) in the validation set. The c-index of combination models was 0.807 (95%CI0.736-0.885) in the training set and 0.840 (95%CI 0.794-0.888) in the validation set. There was no significant change in the c-index of DFS at 1, 2, 3, and over 5 years of follow-up. Conclusion This study has proved that radiomics-based prognostic models are of great predictive performance for the prognosis of breast cancer patients. combination model shows significantly enhanced predictive performance. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022332392.
Collapse
Affiliation(s)
- Dongmei Lu
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Yuke Yan
- The Second Department of General Surgery, Gansu Provincial Hospital, Lanzhou, China
| | - Min Jiang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Shaoqin Sun
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Haifeng Jiang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Yashan Lu
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Wenwen Zhang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| | - Xing Zhou
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, China
| |
Collapse
|
5
|
Stogiannos N, Bougias H, Georgiadou E, Leandrou S, Papavasileiou P. Analysis of radiomic features derived from post-contrast T1-weighted images and apparent diffusion coefficient (ADC) maps for breast lesion evaluation: A retrospective study. Radiography (Lond) 2023; 29:355-361. [PMID: 36758380 DOI: 10.1016/j.radi.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Breast cancer is the most common malignancy among women, and its diagnosis relies on medical imaging and the invasive, uncomforted biopsy. Recent advances in quantitative imaging and specifically the application of radiomics has proved to be a very promising technique, facilitating both diagnosis and therapy. The purpose of this study is to assess radiomic features derived from post-contrast T1w Magnetic Resonance Imaging (MRI) sequences and Apparent Diffusion Coefficient (ADC) maps for the evaluation of breast pathologies. METHODS MRI data from 52 women were retrospectively reviewed, involving 54 breast lesions, both malignant and benign. Diffusion Weighted Imaging (DWI) was applied as a standard MRΙ protocol, including dynamic contrast-enhanced (DCE) MRΙ in all cases. All patients were examined on a 1.5T MRI scanner, and 216 features were initially extracted from DCE-MRI images. Histological analysis of the breast lesions was performed, and a comparative analysis of the results was carried out to assess the accuracy of the method. RESULTS Following surgery and histological analysis, 30 lesions were found to be malignant and 24 benign. Implementation of a Machine Learning (ML) classification algorithm with 5-fold cross-validation resulted in a sensitivity of 70%, specificity of 66%, Negative Predictive Value of 82% and overall accuracy of 67% in differentiating malignancy from benevolence. CONCLUSION Texture analysis and ML methodology based on the first post-contrast dynamic sequences and ADC maps may be employed to differentiate between malignant and benign breast lesions, offering a promising new tool for diagnostic analysis. IMPLICATIONS FOR PRACTICE The results of this study will enhance knowledge around application and performance of radiomics in breast MRI, thus helping MRI radiographers who use AI-enabled technologies to better delineate the pros and cons of these procedures.
Collapse
Affiliation(s)
- N Stogiannos
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Ireland; Division of Midwifery & Radiography, City, University of London, UK; Medical Imaging Department, Corfu General Hospital, Greece, Felix Lames 6A, 1st Parodos, Corfu, Greece.
| | - H Bougias
- Department of Clinical Radiology, Ioannina University Hospital, Ioannina, Greece.
| | | | - S Leandrou
- School of Science, European University Cyprus, Nicosia, Cyprus; School of Mathematical Sciences, Computer Science and Engineering, City, University of London, UK.
| | - P Papavasileiou
- Section of Radiography and Radiotherapy, Dept of Biomedical Sciences, School of Health Sciences, University of West Attica, Athens, Greece.
| |
Collapse
|
6
|
An P, Li X, Qin P, Ye Y, Zhang J, Guo H, Duan P, He Z, Song P, Li M, Wang J, Hu Y, Feng G, Lin Y. Predicting model of mild and severe types of COVID-19 patients using Thymus CT radiomics model: A preliminary study. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:6612-6629. [PMID: 37161120 DOI: 10.3934/mbe.2023284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To predict COVID-19 severity by building a prediction model based on the clinical manifestations and radiomic features of the thymus in COVID-19 patients. METHOD We retrospectively analyzed the clinical and radiological data from 217 confirmed cases of COVID-19 admitted to Xiangyang NO.1 People's Hospital and Jiangsu Hospital of Chinese Medicine from December 2019 to April 2022 (including 118 mild cases and 99 severe cases). The data were split into the training and test sets at a 7:3 ratio. The cases in the training set were compared in terms of clinical data and radiomic parameters of the lasso regression model. Several models for severity prediction were established based on the clinical and radiomic features of the COVID-19 patients. The DeLong test and decision curve analysis (DCA) were used to compare the performances of several models. Finally, the prediction results were verified on the test set. RESULT For the training set, the univariate analysis showed that BMI, diarrhea, thymic steatosis, anorexia, headache, findings on the chest CT scan, platelets, LDH, AST and radiomic features of the thymus were significantly different between the two groups of patients (P < 0.05). The combination model based on the clinical and radiomic features of COVID-19 patients had the highest predictive value for COVID-19 severity [AUC: 0.967 (OR 0.0115, 95%CI: 0.925-0.989)] vs. the clinical feature-based model [AUC: 0.772 (OR 0.0387, 95%CI: 0.697-0.836), P < 0.05], laboratory-based model [AUC: 0.687 (OR 0.0423, 95%CI: 0.608-0.760), P < 0.05] and model based on CT radiomics [AUC: 0.895 (OR 0.0261, 95%CI: 0.835-0.938), P < 0.05]. DCA also confirmed the high clinical net benefits of the combination model. The nomogram drawn based on the combination model could help differentiate between the mild and severe cases of COVID-19 at an early stage. The predictions from different models were verified on the test set. CONCLUSION Severe cases of COVID-19 had a higher level of thymic involution. The thymic differentiation in radiomic features was related to disease progression. The combination model based on the radiomic features of the thymus could better promote early clinical intervention of COVID-19 and increase the cure rate.
Collapse
Affiliation(s)
- Peng An
- Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Xiumei Li
- Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Internal Medicine, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Ping Qin
- Department of Infectious Disease, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Pharmacy and Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - YingJian Ye
- Department of Infectious Disease, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Junyan Zhang
- Department of Pharmacy and Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Hongyan Guo
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Peng Duan
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Zhibing He
- Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Ping Song
- Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Mingqun Li
- Department of Pharmacy and Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Obstetrics and Gynecology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Jinsong Wang
- Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Infectious Disease, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Yan Hu
- Department of Infectious Disease, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Pharmacy and Laboratory, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Guoyan Feng
- Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
- Department of Internal Medicine, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| | - Yong Lin
- Department of Infectious Disease, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
| |
Collapse
|
7
|
Gangil T, Sharan K, Rao BD, Palanisamy K, Chakrabarti B, Kadavigere R. Utility of adding Radiomics to clinical features in predicting the outcomes of radiotherapy for head and neck cancer using machine learning. PLoS One 2022; 17:e0277168. [PMID: 36520945 PMCID: PMC9754241 DOI: 10.1371/journal.pone.0277168] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Radiomics involves the extraction of quantitative information from annotated Computed-Tomography (CT) images, and has been used to predict outcomes in Head and Neck Squamous Cell Carcinoma (HNSCC). Subjecting combined Radiomics and Clinical features to Machine Learning (ML) could offer better predictions of clinical outcomes. This study is a comparative performance analysis of ML models with Clinical, Radiomics, and Clinico-Radiomic datasets for predicting four outcomes of HNSCC treated with Curative Radiation Therapy (RT): Distant Metastases, Locoregional Recurrence, New Primary, and Residual Disease. METHODOLOGY The study used retrospective data of 311 HNSCC patients treated with radiotherapy between 2013-2018 at our centre. Binary prediction models were developed for the four outcomes with Clinical-only, Clinico-Radiomic, and Radiomics-only datasets, using three different ML classification algorithms namely, Random Forest (RF), Kernel Support Vector Machine (KSVM), and XGBoost. The best-performing ML algorithms of the three dataset groups was then compared. RESULTS The Clinico-Radiomic dataset using KSVM classifier provided the best prediction. Predicted mean testing accuracy for Distant Metastases, Locoregional Recurrence, New Primary, and Residual Disease was 97%, 72%, 99%, and 96%, respectively. The mean area under the receiver operating curve (AUC) was calculated and displayed for all the models using three dataset groups. CONCLUSION Clinico-Radiomic dataset improved the predictive ability of ML models over clinical features alone, while models built using Radiomics performed poorly. Radiomics data could therefore effectively supplement clinical data in predicting outcomes.
Collapse
Affiliation(s)
- Tarun Gangil
- Department of Radiotherapy and Oncology, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Krishna Sharan
- Department of Radiotherapy and Oncology, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - B. Dinesh Rao
- Manipal School of Information Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - Rajagopal Kadavigere
- Department of Radiology, Kasturba Medical College-Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- * E-mail:
| |
Collapse
|
8
|
Azadikhah A, Varghese BA, Lei X, Martin-King C, Cen SY, Duddalwar VA. Radiomics quality score in renal masses: a systematic assessment on current literature. Br J Radiol 2022; 95:20211211. [PMID: 35671097 PMCID: PMC10996962 DOI: 10.1259/bjr.20211211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To perform a systematic assessment and analyze the quality of radiomics methodology in current literature in the evaluation of renal masses using the Radiomics Quality Score (RQS) approach. METHODS We systematically reviewed recent radiomics literature in renal masses published in PubMed, EMBASE, Elsevier, and Web of Science. Two reviewers blinded by each other's scores evaluated the quality of radiomics methodology in studies published from 2015 to August 2021 using the RQS approach. Owing to the diversity in the imaging modalities and radiomics applications, a meta-analysis could not be performed. RESULTS Based on our inclusion/exclusion criteria, a total of 87 published studies were included in our study. The highest RQS was noted in three categories: reporting of clinical utility, gold standard, and feature reduction. The average RQS of the two reviewers ranged from 5 ≤ RQS≤19, with the maximum attainable RQS being 36. Very few (7/87 i.e., 8%) studies received an average RQS that ranged from 17 < RQS≤19, which represents studies with the highest RQS in our study. Many (39/87 i.e., 45%) studies received an average RQS that ranged from 13 < RQS≤15. No significant interreviewer scoring differences were observed. CONCLUSIONS We report that the overall scientific quality and reporting of radiomics studies in renal masses is suboptimal, and subsequent studies should bolster current deficiencies to improve reporting of radiomics methodologies. ADVANCES IN KNOWLEDGE The RQS approach is a meaningful quantitative scoring system to assess radiomics methodology quality and supports a comprehensive evaluation of the radiomics approach before its incorporation into clinical practice.
Collapse
Affiliation(s)
- Afshin Azadikhah
- USC Radiomics Laboratory, Department of Radiology, Keck School
of Medicine, University of Southern California,
Los Angeles, United States
| | - Bino Abel Varghese
- USC Radiomics Laboratory, Department of Radiology, Keck School
of Medicine, University of Southern California,
Los Angeles, United States
| | - Xiaomeng Lei
- USC Radiomics Laboratory, Department of Radiology, Keck School
of Medicine, University of Southern California,
Los Angeles, United States
| | - Chloe Martin-King
- USC Radiomics Laboratory, Department of Radiology, Keck School
of Medicine, University of Southern California,
Los Angeles, United States
| | - Steven Yong Cen
- USC Radiomics Laboratory, Department of Radiology, Keck School
of Medicine, University of Southern California,
Los Angeles, United States
| | - Vinay Anant Duddalwar
- USC Radiomics Laboratory, Department of Radiology, Keck School
of Medicine, University of Southern California,
Los Angeles, United States
| |
Collapse
|
9
|
Vamvakas A, Tsivaka D, Logothetis A, Vassiou K, Tsougos I. Breast Cancer Classification on Multiparametric MRI - Increased Performance of Boosting Ensemble Methods. Technol Cancer Res Treat 2022; 21:15330338221087828. [PMID: 35341421 PMCID: PMC8966070 DOI: 10.1177/15330338221087828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Introduction: This study aims to assess the utility of Boosting ensemble classification methods for increasing the diagnostic performance of multiparametric Magnetic Resonance Imaging (mpMRI) radiomic models, in differentiating benign and malignant breast lesions. Methods: The dataset includes mpMR images of 140 female patients with mass-like breast lesions (70 benign and 70 malignant), consisting of Dynamic Contrast Enhanced (DCE) and T2-weighted sequences, and the Apparent Diffusion Coefficient (ADC) calculated from the Diffusion Weighted Imaging (DWI) sequence. Tumor masks were manually defined in all consecutive slices of the respective MRI volumes and 3D radiomic features were extracted with the Pyradiomics package. Feature dimensionality reduction was based on statistical tests and the Boruta wrapper. Hierarchical Clustering on Spearman's rank correlation coefficients between features and Random Forest classification for obtaining feature importance, were implemented for selecting the final feature subset. Adaptive Boosting (AdaBoost), Gradient Boosting (GB), Extreme Gradient Boosting (XGBoost) and Light Gradient Boosting Machine (LightGBM) classifiers, were trained and tested with bootstrap validation in differentiating breast lesions. A Support Vector Machine (SVM) classifier was also exploited for comparison. The Receiver Operator Characteristic (ROC) curves and DeLong's test were utilized to evaluate the classification performances. Results: The final feature subset consisted of 5 features derived from the lesion shape and the first order histogram of DCE and ADC images volumes. XGboost and LGBM achieved statistically significantly higher average classification performances [AUC = 0.95 and 0.94 respectively], followed by Adaboost [AUC = 0.90], GB [AUC = 0.89] and SVM [AUC = 0.88]. Conclusion: Overall, the integration of Ensemble Learning methods within mpMRI radiomic analysis can improve the performance of computer-assisted diagnosis of breast cancer lesions.
Collapse
Affiliation(s)
- Alexandros Vamvakas
- Medical Physics Department, Medical School, 37786University of Thessaly, Larissa, Greece
| | - Dimitra Tsivaka
- Medical Physics Department, Medical School, 37786University of Thessaly, Larissa, Greece
| | - Andreas Logothetis
- Medical Physics Laboratory, Medical School, 393206National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Vassiou
- Department of Anatomy and Radiology, Medical School, 37786University of Thessaly, Larissa, Greece
| | - Ioannis Tsougos
- Medical Physics Department, Medical School, 37786University of Thessaly, Larissa, Greece
| |
Collapse
|
10
|
Machine Learning: Applications and Advanced Progresses of Radiomics in Endocrine Neoplasms. JOURNAL OF ONCOLOGY 2021; 2021:8615450. [PMID: 34671399 PMCID: PMC8523238 DOI: 10.1155/2021/8615450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/13/2021] [Accepted: 09/20/2021] [Indexed: 12/24/2022]
Abstract
Endocrine neoplasms remain a great threat to human health. It is extremely important to make a clear diagnosis and timely treatment of endocrine tumors. Machine learning includes radiomics, which has long been utilized in clinical cancer research. Radiomics refers to the extraction of valuable information by analyzing a large amount of standard data with high-throughput medical images mainly including computed tomography, positron emission tomography, magnetic resonance imaging, and ultrasound. With the quantitative imaging analysis and model building, radiomics can reflect specific underlying characteristics of a disease that otherwise could not be evaluated visually. More and more promising results of radiomics in oncological practice have been seen in recent years. Radiomics may have the potential to supplement traditional imaging analysis and assist in providing precision medicine for patients. Radiomics had developed rapidly in endocrine neoplasms practice in the past decade. In this review, we would introduce the general workflow of radiomics and summarize the applications and developments of radiomics in endocrine neoplasms in recent years. The limitations of current radiomic research studies and future development directions would also be discussed.
Collapse
|
11
|
Radiomics as a New Frontier of Imaging for Cancer Prognosis: A Narrative Review. Diagnostics (Basel) 2021; 11:diagnostics11101796. [PMID: 34679494 PMCID: PMC8534713 DOI: 10.3390/diagnostics11101796] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/12/2022] Open
Abstract
The evaluation of the efficacy of different therapies is of paramount importance for the patients and the clinicians in oncology, and it is usually possible by performing imaging investigations that are interpreted, taking in consideration different response evaluation criteria. In the last decade, texture analysis (TA) has been developed in order to help the radiologist to quantify and identify parameters related to tumor heterogeneity, which cannot be appreciated by the naked eye, that can be correlated with different endpoints, including cancer prognosis. The aim of this work is to analyze the impact of texture in the prediction of response and in prognosis stratification in oncology, taking into consideration different pathologies (lung cancer, breast cancer, gastric cancer, hepatic cancer, rectal cancer). Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. This paper contains a narrative report and a critical discussion of radiomics approaches related to cancer prognosis in different fields of diseases.
Collapse
|
12
|
Li X, Cui L, Zhang GQ, Lhatoo SD. Can Big Data guide prognosis and clinical decisions in epilepsy? Epilepsia 2021; 62 Suppl 2:S106-S115. [PMID: 33529363 PMCID: PMC8011949 DOI: 10.1111/epi.16786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 01/16/2023]
Abstract
Big Data is no longer a novel concept in health care. Its promise of positive impact is not only undiminished, but daily enhanced by seemingly endless possibilities. Epilepsy is a disorder with wide heterogeneity in both clinical and research domains, and thus lends itself to Big Data concepts and techniques. It is therefore inevitable that Big Data will enable multimodal research, integrating various aspects of "-omics" domains, such as phenome, genome, microbiome, metabolome, and proteome. This scope and granularity have the potential to change our understanding of prognosis and mortality in epilepsy. The scale of new discovery is unprecedented due to the possibilities promised by advances in machine learning, in particular deep learning. The subsequent possibilities of personalized patient care through clinical decision support systems that are evidence-based, adaptive, and iterative seem to be within reach. A major objective is not only to inform decision-making, but also to reduce uncertainty in outcomes. Although the adoption of electronic health record (EHR) systems is near universal in the United States, for example, advanced clinical decision support in or ancillary to EHRs remains sporadic. In this review, we discuss the role of Big Data in the development of clinical decision support systems for epilepsy care, prognostication, and discovery.
Collapse
Affiliation(s)
- Xiaojin Li
- Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Licong Cui
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Guo-Qiang Zhang
- Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Samden D. Lhatoo
- Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA
| |
Collapse
|
13
|
Tao W, Lu M, Zhou X, Montemezzi S, Bai G, Yue Y, Li X, Zhao L, Zhou C, Lu G. Machine Learning Based on Multi-Parametric MRI to Predict Risk of Breast Cancer. Front Oncol 2021; 11:570747. [PMID: 33718131 PMCID: PMC7952867 DOI: 10.3389/fonc.2021.570747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/18/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose Machine learning (ML) can extract high-throughput features of images to predict disease. This study aimed to develop nomogram of multi-parametric MRI (mpMRI) ML model to predict the risk of breast cancer. Methods The mpMRI included non-enhanced and enhanced T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), apparent diffusion coefficient (ADC), K trans, K ep, V e, and V p. Regions of interest were annotated in an enhanced T1WI map and mapped to other maps in every slice. 1,132 features and top-10 principal components were extracted from every parameter map. Single-parametric and multi-parametric ML models were constructed via 10 rounds of five-fold cross-validation. The model with the highest area under the curve (AUC) was considered as the optimal model and validated by calibration curve and decision curve. Nomogram was built with the optimal ML model and patients' characteristics. Results This study involved 144 malignant lesions and 66 benign lesions. The average age of patients with benign and malignant lesions was 42.5 years old and 50.8 years old, respectively, which were statistically different. The sixth and fourth principal components of K trans had more importance than others. The AUCs of K trans, K ep, V e and V p, non-enhanced T1WI, enhanced T1WI, T2WI, and ADC models were 0.86, 0.81, 0.81, 0.83, 0.79, 0.81, 0.84, and 0.83 respectively. The model with an AUC of 0.90 was considered as the optimal model which was validated by calibration curve and decision curve. Nomogram for the prediction of breast cancer was built with the optimal ML models and patient age. Conclusion Nomogram could improve the ability of breast cancer prediction preoperatively.
Collapse
Affiliation(s)
- Weijing Tao
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.,Department of Nuclear Medicine, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Mengjie Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaoyu Zhou
- Faculty of Mechanical Electronic and Information Engineering, Jiangsu Vocational College of Finance and Economics, Huai'an, China
| | - Stefania Montemezzi
- Radiology Unit, Department of Pathology and Diagnostics, Azienda Ospedaliera Universitaria Integrata-Verona, Verona, Italy
| | - Genji Bai
- Department of Radiology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Yangming Yue
- Deepwise AI Laboratory, Deepwise Inc., Beijing, China
| | - Xiuli Li
- Deepwise AI Laboratory, Deepwise Inc., Beijing, China
| | - Lun Zhao
- Deepwise AI Laboratory, Deepwise Inc., Beijing, China
| | - Changsheng Zhou
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
14
|
Pathak P, Jalal AS, Rai R. Breast Cancer Image Classification: A Review. Curr Med Imaging 2020; 17:720-740. [PMID: 33371857 DOI: 10.2174/0929867328666201228125208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/23/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Breast cancer represents uncontrolled breast cell growth. Breast cancer is the most diagnosed cancer in women worldwide. Early detection of breast cancer improves the chances of survival and increases treatment options. There are various methods for screening breast cancer, such as mammogram, ultrasound, computed tomography and Magnetic Resonance Imaging (MRI). MRI is gaining prominence as an alternative screening tool for early detection and breast cancer diagnosis. Nevertheless, MRI can hardly be examined without the use of a Computer-Aided Diagnosis (CAD) framework, due to the vast amount of data. OBJECTIVE This paper aims to cover the approaches used in the CAD system for the detection of breast cancer. METHODS In this paper, the methods used in CAD systems are categories into two classes: the conventional approach and artificial intelligence (AI) approach. RESULTS The conventional approach covers the basic steps of image processing, such as preprocessing, segmentation, feature extraction and classification. The AI approach covers the various convolutional and deep learning networks used for diagnosis. CONCLUSION This review discusses some of the core concepts used in breast cancer and presents a comprehensive review of efforts in the past to address this problem.
Collapse
Affiliation(s)
- Pooja Pathak
- Department of Mathematics, GLA University, Mathura, India
| | - Anand Singh Jalal
- Department of Computer Engineering & Applications, GLA University, Mathura, India
| | - Ritu Rai
- Department of Computer Engineering & Applications, GLA University, Mathura, India
| |
Collapse
|
15
|
Conti A, Duggento A, Indovina I, Guerrisi M, Toschi N. Radiomics in breast cancer classification and prediction. Semin Cancer Biol 2020; 72:238-250. [PMID: 32371013 DOI: 10.1016/j.semcancer.2020.04.002] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 12/15/2022]
Abstract
Breast Cancer (BC) is the common form of cancer in women. Its diagnosis and screening are usually performed through different imaging modalities such as mammography, magnetic resonance imaging and ultrasound. However, mammography and ultrasound-imaging techniques have limited sensitivity and specificity both in identifying lesions and in differentiating malign from benign lesions, especially in presence of dense breast parenchyma. Due to the higher resolution of magnetic resonance images, MRI represents the method with the higher specificity and sensitivity among all the available tools, in both lesions' identification and diagnosis. However, especially for diagnosis, even MRI has limitations that are only partially solved if combined with mammography. Unfortunately, due to the limits of all these imaging tools, in order to have a certain diagnosis, patients often receive painful and costly bioptics procedures. In this context, several computational approaches have been developed to increase sensitivity, while maintaining the same specificity, in BC diagnosis and screening. Amongst these, radiomics has been increasingly gaining ground in oncology to improve cancer diagnosis, prognosis and treatment. Radiomics derives multiple quantitative features from single or multiple medical imaging modalities, highlighting image traits which are not visible to the naked eye and hence significantly augmenting the discriminatory and predictive potential of medical imaging. This review article aims to summarize the state of the art in radiomics-based BC research. The dominating evidence extracted from the literature points towards a high potential of radiomics in disentangling malignant from benign breast lesions, classifying BC types and grades and also in predicting treatment response and recurrence risk. In the era of personalized medicine, radiomics has the potential to improve diagnosis, prognosis, prediction, monitoring, image-based intervention, and assessment of therapeutic response in BC.
Collapse
Affiliation(s)
- Allegra Conti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Andrea Duggento
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Iole Indovina
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy; Department of Medicine and Surgery, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States.
| |
Collapse
|
16
|
Zhou J, Zhang Y, Chang KT, Lee KE, Wang O, Li J, Lin Y, Pan Z, Chang P, Chow D, Wang M, Su MY. Diagnosis of Benign and Malignant Breast Lesions on DCE-MRI by Using Radiomics and Deep Learning With Consideration of Peritumor Tissue. J Magn Reson Imaging 2019; 51:798-809. [PMID: 31675151 DOI: 10.1002/jmri.26981] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Computer-aided methods have been widely applied to diagnose lesions detected on breast MRI, but fully-automatic diagnosis using deep learning is rarely reported. PURPOSE To evaluate the diagnostic accuracy of mass lesions using region of interest (ROI)-based, radiomics and deep-learning methods, by taking peritumor tissues into consideration. STUDY TYPE Retrospective. POPULATION In all, 133 patients with histologically confirmed 91 malignant and 62 benign mass lesions for training (74 patients with 48 malignant and 26 benign lesions for testing). FIELD STRENGTH/SEQUENCE 3T, using the volume imaging for breast assessment (VIBRANT) dynamic contrast-enhanced (DCE) sequence. ASSESSMENT 3D tumor segmentation was done automatically by using fuzzy-C-means algorithm with connected-component labeling. A total of 99 texture and histogram parameters were calculated for each case, and 15 were selected using random forest to build a radiomics model. Deep learning was implemented using ResNet50, evaluated with 10-fold crossvalidation. The tumor alone, smallest bounding box, and 1.2, 1.5, 2.0 times enlarged boxes were used as inputs. STATISTICAL TESTS The malignancy probability was calculated using each model, and the threshold of 0.5 was used to make a diagnosis. RESULTS In the training dataset, the diagnostic accuracy was 76% using three ROI-based parameters, 84% using the radiomics model, and 86% using ROI + radiomics model. In deep learning using the per-slice basis, the area under the receiver operating characteristic (ROC) was comparable for tumor alone, smallest and 1.2 times box (AUC = 0.97-0.99), which were significantly higher than 1.5 and 2.0 times box (AUC = 0.86 and 0.71, respectively). For per-lesion diagnosis, the highest accuracy of 91% was achieved when using the smallest bounding box, and that decreased to 84% for tumor alone and 1.2 times box, and further to 73% for 1.5 times box and 69% for 2.0 times box. In the independent testing dataset, the per-lesion diagnostic accuracy was also the highest when using the smallest bounding box, 89%. DATA CONCLUSION Deep learning using ResNet50 achieved a high diagnostic accuracy. Using the smallest bounding box containing proximal peritumor tissue as input had higher accuracy compared to using tumor alone or larger boxes. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2.
Collapse
Affiliation(s)
- Jiejie Zhou
- Department of Radiology, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yang Zhang
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Kai-Ting Chang
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Kyoung Eun Lee
- Department of Radiology, Inje University Seoul Paik Hospital, Inje University, Seoul, Korea
| | - Ouchen Wang
- Department of Thyroid and Breast Surgery, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiance Li
- Department of Radiology, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yezhi Lin
- Information Technology Center, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhifang Pan
- Information Technology Center, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peter Chang
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Daniel Chow
- Department of Radiological Sciences, University of California, Irvine, California, USA
| | - Meihao Wang
- Department of Radiology, First Affiliate Hospital of Wenzhou Medical University, Wenzhou, China
| | - Min-Ying Su
- Department of Radiological Sciences, University of California, Irvine, California, USA
| |
Collapse
|