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Jiang X, Li T, Wang J, Zhang Z, Chen X, Zhang J, Zhao X. Noninvasive Assessment of HER2 Expression Status in Gastric Cancer Using 18F-FDG Positron Emission Tomography/Computed Tomography-Based Radiomics: A Pilot Study. Cancer Biother Radiopharm 2024; 39:169-177. [PMID: 38193811 DOI: 10.1089/cbr.2023.0162] [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] [Indexed: 01/10/2024] Open
Abstract
Purpose: Immunohistochemistry (IHC) is the main method to detect human epidermal growth factor receptor 2 (HER2) expression levels. However, IHC is invasive and cannot reflect HER2 expression status in real time. The aim of this study was to construct and verify three types of radiomics models based on 18F-fuorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging and to evaluate the predictive ability of these radiomics models for the expression status of HER2 in patients with gastric cancer (GC). Patients and Methods: A total of 118 patients with GC were enrolled in this study. 18F-FDG PET/CT imaging was performed prior to surgery. The LIFEx software package was applied to extract PET and CT radiomics features. The minimum absolute contraction and selection operator (least absolute shrinkage and selection operator [LASSO]) algorithm was used to select the best radiomics features. Three machine learning methods, logistic regression (LR), support vector machine (SVM), and random forest (RF) models, were constructed and verified. The Synthetic Minority Oversampling Technique (SMOTE) was applied to address data imbalance. Results: In the training and test sets, the area under the curve (AUC) values of the LR, SVM, and RF models were 0.809, 0.761, 0.861 and 0.628, 0.993, 0.717, respectively, and the Brier scores were 0.118, 0.214, and 0.143, respectively. Among the three models, the LR and RF models exhibited extremely good prediction performance. The AUC values of the three models significantly improved after SMOTE balanced the data. Conclusions: 18F-FDG PET/CT-based radiomics models, especially LR and RF models, demonstrate good performance in predicting HER2 expression status in patients with GC and can be used to preselect patients who may benefit from HER2-targeted therapy.
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Affiliation(s)
- Xiaojing Jiang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianyue Li
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jianfang Wang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhaoqi Zhang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaolin Chen
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jingmian Zhang
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
| | - Xinming Zhao
- Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China
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Tian S, Yu R, Zhou F, Zhan N, Li J, Wang X, Peng X. Prediction of HER2 status via random forest in 3257 Chinese patients with gastric cancer. Clin Exp Med 2023; 23:5015-5024. [PMID: 37318648 DOI: 10.1007/s10238-023-01111-3] [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: 02/27/2023] [Accepted: 05/29/2023] [Indexed: 06/16/2023]
Abstract
The accurate evaluation of human epidermal growth factor receptor 2 (HER2) is crucial for successful trastuzumab-based therapy in individuals with gastric cancer (GC). The present study, involving a retrospective cohort (N = 2865) from Wuhan Union Hospital and a prospective cohort (N = 392) from Renmin Hospital of Wuhan University, evaluated the benefits of clinical features using random forest and logistic regression models for the detection of HER2 status in patients with GC. Patients from the Union cohort were randomly assigned to either a training (N = 2005) or an internal validation (N = 860) group. Data processing and feature selection were done in Python, which was also used to build random forest and logistic regression models for the prediction of HER2 overexpression. The Renmin cohort (N = 392) was used as the external validation group. Ten features were closely correlated with HER2 overexpression, including age, albumin/globulin ratio, globulin, activated partial thromboplastin time, tumor stage, node stage, tumor node metastasis stage, tumor size, tumor differentiation, and neuron-specific enolase (NSE). Random forest and logistic regression had areas under the curve (AUC) of 0.9995 and 0.6653 in the training group and 0.923 and 0.667 in the internal validation group, respectively. When the two predictive models were validated using data from the Renmin cohort, random forest and logistic regression had AUCs of 0.9994 and 0.627, respectively. This is the first multicenter study to predict HER2 overexpression in individuals with GC, based on clinical variables. The random forest model significantly outperformed the logistic regression model.
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Affiliation(s)
- Shan Tian
- Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Rong Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Fangfang Zhou
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Na Zhan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Jiao Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Xia Wang
- Department of Pharmacy, The Second Affiliated Hospital of Jianghan University, No.122, Xianzheng Road, Hanyang District, Wuhan, 430050, Hubei, China.
| | - Xiulan Peng
- Department of Oncology, The Second Affiliated Hospital of Jianghan University, No.122, Xianzheng Road, Hanyang District, Wuhan, 430050, Hubei Province, China.
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Xie J, Xue B, Bian S, Ji X, Lin J, Zheng X, Tang K. A radiomics nomogram based on 18 F-FDG PET/CT and clinical risk factors for the prediction of peritoneal metastasis in gastric cancer. Nucl Med Commun 2023; 44:977-987. [PMID: 37578301 DOI: 10.1097/mnm.0000000000001742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
PURPOSE Peritoneal metastasis (PM) is usually considered an incurable factor of gastric cancer (GC) and not fit for surgery. The aim of this study is to develop and validate an 18 F-FDG PET/CT-derived radiomics model combining with clinical risk factors for predicting PM of GC. METHOD In this retrospective study, 410 GC patients (PM - = 281, PM + = 129) who underwent preoperative 18 F-FDG PET/CT images from January 2015 to October 2021 were analyzed. The patients were randomly divided into a training cohort (n = 288) and a validation cohort (n = 122). The maximum relevance and minimum redundancy (mRMR) and the least shrinkage and selection operator method were applied to select feature. Multivariable logistic regression analysis was preformed to develop the predicting model. Discrimination, calibration, and clinical usefulness were used to evaluate the performance of the nomogram. RESULT Fourteen radiomics feature parameters were selected to construct radiomics model. The area under the curve (AUC) of the radiomics model were 0.86 [95% confidence interval (CI), 0.81-0.90] in the training cohort and 0.85 (95% CI, 0.78-0.92) in the validation cohort. After multivariable logistic regression, peritoneal effusion, mean standardized uptake value (SUVmean), carbohydrate antigen 125 (CA125) and radiomics signature showed statistically significant differences between different PM status patients( P < 0.05). They were chosen to construct the comprehensive predicting model which showed a performance with an AUC of 0.92 (95% CI, 0.89-0.95) in the training cohort and 0.92 (95% CI, 0.86-0.98) in the validation cohort, respectively. CONCLUSION The nomogram based on 18 F-FDG PET/CT radiomics features and clinical risk factors can be potentially applied in individualized treatment strategy-making for GC patients before the surgery.
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Affiliation(s)
- Jiageng Xie
- Departments of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Beihui Xue
- Departments of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shuying Bian
- Departments of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaowei Ji
- Departments of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jie Lin
- Departments of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiangwu Zheng
- Departments of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Kun Tang
- Departments of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Hu Z, Liang H, Zhao H, Hou F, Hao D, Ji Q, Huang C, Xu J, Tian L, Wang H. Preoperative contrast-enhanced CT-based radiomics signature for predicting hypoxia-inducible factor 1α expression in retroperitoneal sarcoma. Clin Radiol 2023; 78:e543-e551. [PMID: 37080804 DOI: 10.1016/j.crad.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/27/2023] [Accepted: 03/19/2023] [Indexed: 04/05/2023]
Abstract
AIM To develop and test a contrast-enhanced computed tomography (CECT)-based radiomics signature (RS) to preoperatively predict hypoxia-inducible factor 1α (HIF-1α) expression in retroperitoneal sarcoma (RPS). MATERIALS AND METHODS This study included 129 patients with RPS retrospectively who underwent CECT, including 64 male and 65 female patients (55 [2-84] years). Participants were divided into a training set comprising 85 patients and a test set comprising 44 patients. Clinical data and CECT findings of all patients were collected. RS construction was performed by the minimum redundancy maximum relevance method and least absolute shrinkage and selection operator algorithm. The clinical information was analysed by univariate and multivariate logistic regression analysis. The RS and risk factors were included to build a radiomics nomogram. The predictive efficacy of different models was evaluated by accuracy, area under the receiver operating characteristic curve (AUC), and decision curve analysis. RESULTS The RS combined signature was constructed on the basis of multi-phase CECT and had an accuracy of 0.795 and an AUC of 0.719 (95% confidence interval [CI], 0.552-0.886) in the test set, which were higher than that of the radiomics nomogram (accuracy: 0.636; AUC: 0.702 [95% CI, 0.547-0.857]) and the clinical model (accuracy: 0.682; AUC: 0.486 [95% CI, 0.324-0.647]). The decision curve analysis showed that the RS combined signature provided better clinical application than the clinical model and radiomics nomogram. CONCLUSIONS The multi-phase CECT-based RS constructed can be used as a powerful tool for predicting HIF-1α expression in patients with RPS.
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Affiliation(s)
- Z Hu
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - H Liang
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - H Zhao
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - F Hou
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - D Hao
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Q Ji
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - C Huang
- Department of Research Collaboration, Research and Development (R&D) Center, Beijing Deepwise & League of Philosophy Doctor (PHD) Technology Co., Ltd, Beijing, 100089, China
| | - J Xu
- Department of Research Collaboration, Research and Development (R&D) Center, Beijing Deepwise & League of Philosophy Doctor (PHD) Technology Co., Ltd, Beijing, 100089, China
| | - L Tian
- Department of Hepatopancreatobiliary & Retroperitoneal Tumour Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
| | - H Wang
- Department of Radiology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
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Jiang Z, Xie W, Zhou X, Pan W, Jiang S, Zhang X, Zhang M, Zhang Z, Lu Y, Wang D. A virtual biopsy study of microsatellite instability in gastric cancer based on deep learning radiomics. Insights Imaging 2023; 14:104. [PMID: 37286810 DOI: 10.1186/s13244-023-01438-1] [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: 03/09/2023] [Accepted: 04/15/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES This study aims to develop and validate a virtual biopsy model to predict microsatellite instability (MSI) status in preoperative gastric cancer (GC) patients based on clinical information and the radiomics of deep learning algorithms. METHODS A total of 223 GC patients with MSI status detected by postoperative immunohistochemical staining (IHC) were retrospectively recruited and randomly assigned to the training (n = 167) and testing (n = 56) sets in a 3:1 ratio. In the training set, 982 high-throughput radiomic features were extracted from preoperative abdominal dynamic contrast-enhanced CT (CECT) and screened. According to the deep learning multilayer perceptron (MLP), 15 optimal features were optimized to establish the radiomic feature score (Rad-score), and LASSO regression was used to screen out clinically independent predictors. Based on logistic regression, the Rad-score and clinically independent predictors were integrated to build the clinical radiomics model and visualized as a nomogram and independently verified in the testing set. The performance and clinical applicability of hybrid model in identifying MSI status were evaluated by the area under the receiver operating characteristic (AUC) curve, calibration curve, and decision curve (DCA). RESULTS The AUCs of the clinical image model in training set and testing set were 0.883 [95% CI: 0.822-0.945] and 0.802 [95% CI: 0.666-0.937], respectively. This hybrid model showed good consistency in the calibration curve and clinical applicability in the DCA curve, respectively. CONCLUSIONS Using preoperative imaging and clinical information, we developed a deep-learning-based radiomics model for the non-invasive evaluation of MSI in GC patients. This model maybe can potentially support clinical treatment decision making for GC patients.
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Affiliation(s)
- Zinian Jiang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Wentao Xie
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China
| | - Xiaoming Zhou
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Wenjun Pan
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Sheng Jiang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China
| | - Xianxiang Zhang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China
| | - Maoshen Zhang
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China
| | - Zhenqi Zhang
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yun Lu
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China.
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China.
- Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, Qingdao, Shandong, China.
| | - Dongsheng Wang
- Qingdao Medical College, Qingdao University, Qingdao, Shandong, China.
- Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, No. 1677, Wutaishan Road, Qingdao, 266000, Shandong, China.
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Liu Q, Li J, Xin B, Sun Y, Wang X, Song S. Preoperative 18F-FDG PET/CT radiomics analysis for predicting HER2 expression and prognosis in gastric cancer. Quant Imaging Med Surg 2023; 13:1537-1549. [PMID: 36915308 PMCID: PMC10006101 DOI: 10.21037/qims-22-148] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 12/18/2022] [Indexed: 02/16/2023]
Abstract
Background We aimed to establish and validate 2 machine learning models using 18F-flurodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) radiomic features to predict human epidermal growth factor receptor 2 (HER2) expression and prognosis in gastric cancer (GC) patients. Methods We retrospectively enrolled 90 patients diagnosed with GC, including their clinical information and the 18F-FDG PET/CT images. Patients were allocated to a training cohort of 72 patients and an independent validation cohort (IVC) of 18 patients. There were 2,100 radiomic features extracted from the 18F-FDG PET/CT scans. A sequential combination of multivariate and univariate feature selection was applied, including sequential forward selection and a redundancy-based analysis. The justification of the model performance was conducted by cross-validation analysis on the training set and an independent validation analysis. Results The machine learning models were developed using a balanced bagging approach for HER2 expression prediction and prognosis prediction, which differentiated HER2 positive expression from negative expression in the IVC with an area under the receiver operating characteristic curve (AUC) of 0.72, sensitivity of 0.85, and specificity of 0.80. The IVC for prognosis prediction achieved an AUC of 0.75, sensitivity of 0.82, and specificity of 0.71. We also conducted a reasonable interpretation for the selected features in each classification task from multiple aspects, including normalized feature importance analysis and statistical correlation analysis with the clinical features that were defaulted to be effective. Conclusions 18F-FDG PET/CT radiomics analysis with a machine learning model provides a quantitative, efficient, and objective mechanism for predicting HER2 expression and prognosis in GC patients.
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Affiliation(s)
- Qiufang Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaru Li
- School of Computer Science, The University of Sydney, Sydney, Australia
| | - Bowen Xin
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Sydney, Australia
| | - Yuyun Sun
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiuying Wang
- School of Computer Science, The University of Sydney, Sydney, Australia
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Zhao H, Liang P, Yong L, Cheng M, Zhang Y, Huang M, Gao J. Development and external validation of a radiomics model for assessment of HER2 positivity in men and women presenting with gastric cancer. Insights Imaging 2023; 14:20. [PMID: 36720737 PMCID: PMC9889592 DOI: 10.1186/s13244-022-01361-x] [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: 10/06/2022] [Accepted: 12/19/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND To develop and externally validate a conventional CT-based radiomics model for identifying HER2-positive status in gastric cancer (GC). METHODS 950 GC patients who underwent pretreatment CT were retrospectively enrolled and assigned into a training cohort (n = 388, conventional CT), an internal validation cohort (n = 325, conventional CT) and an external validation cohort (n = 237, dual-energy CT, DECT). Radiomics features were extracted from venous phase images to construct the "Radscore". On the basis of univariate and multivariate analyses, a conventional CT-based radiomics model was built in the training cohort, combining significant clinical-laboratory characteristics and Radscore. The model was assessed and validated regarding its diagnostic effectiveness and clinical practicability using AUC and decision curve analysis, respectively. RESULTS Location, clinical TNM staging, CEA, CA199, and Radscore were independent predictors of HER2 status (all p < 0.05). Integrating these five indicators, the proposed model exerted a favorable diagnostic performance with AUCs of 0.732 (95%CI 0.683-0.781), 0.703 (95%CI 0.624-0.783), and 0.711 (95%CI 0.625-0.798) observed for the training, internal validation, and external validation cohorts, respectively. Meanwhile, the model would offer more net benefits than the default simple schemes and its performance was not affected by the age, gender, location, immunohistochemistry results, and type of tissue for confirmation (all p > 0.05). CONCLUSIONS The conventional CT-based radiomics model had a good diagnostic performance of HER2 positivity in GC and the potential to generalize to DECT, which is beneficial to simplify clinical workflow and help clinicians initially identify potential candidates who might benefit from HER2-targeted therapy.
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Affiliation(s)
- Huiping Zhao
- grid.440288.20000 0004 1758 0451Department of CT, Shaanxi Provincial People’s Hospital, No. 256, Youyi West Road, Xi’an, 710068 Shaanxi Province China ,grid.412633.10000 0004 1799 0733Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China ,Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor & Henan International Joint Laboratory of Medical Imaging & Henan Engineering Laboratory of Tumor Imaging & Henan Key Laboratory of CT Imaging & Zhengzhou Key Laboratory of Medical Imaging Technology and Diagnosis, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China
| | - Pan Liang
- grid.412633.10000 0004 1799 0733Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China ,Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor & Henan International Joint Laboratory of Medical Imaging & Henan Engineering Laboratory of Tumor Imaging & Henan Key Laboratory of CT Imaging & Zhengzhou Key Laboratory of Medical Imaging Technology and Diagnosis, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China
| | - Liuliang Yong
- grid.412633.10000 0004 1799 0733Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China ,Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor & Henan International Joint Laboratory of Medical Imaging & Henan Engineering Laboratory of Tumor Imaging & Henan Key Laboratory of CT Imaging & Zhengzhou Key Laboratory of Medical Imaging Technology and Diagnosis, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China
| | - Ming Cheng
- Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor & Henan International Joint Laboratory of Medical Imaging & Henan Engineering Laboratory of Tumor Imaging & Henan Key Laboratory of CT Imaging & Zhengzhou Key Laboratory of Medical Imaging Technology and Diagnosis, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China ,grid.412633.10000 0004 1799 0733Department of Medical Information, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China
| | - Yan Zhang
- grid.440288.20000 0004 1758 0451Department of CT, Shaanxi Provincial People’s Hospital, No. 256, Youyi West Road, Xi’an, 710068 Shaanxi Province China
| | - Minggang Huang
- grid.440288.20000 0004 1758 0451Department of CT, Shaanxi Provincial People’s Hospital, No. 256, Youyi West Road, Xi’an, 710068 Shaanxi Province China
| | - Jianbo Gao
- grid.412633.10000 0004 1799 0733Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China ,Henan Key Laboratory of Image Diagnosis and Treatment for Digestive System Tumor & Henan International Joint Laboratory of Medical Imaging & Henan Engineering Laboratory of Tumor Imaging & Henan Key Laboratory of CT Imaging & Zhengzhou Key Laboratory of Medical Imaging Technology and Diagnosis, No. 1, East Jianshe Road, Zhengzhou, 450052 Henan Province China
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Guan X, Lu N, Zhang J. Accurate preoperative staging and HER2 status prediction of gastric cancer by the deep learning system based on enhanced computed tomography. Front Oncol 2022; 12:950185. [PMID: 36452488 PMCID: PMC9702985 DOI: 10.3389/fonc.2022.950185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/24/2022] [Indexed: 10/24/2023] Open
Abstract
PURPOSE To construct the deep learning system (DLS) based on enhanced computed tomography (CT) images for preoperative prediction of staging and human epidermal growth factor receptor 2 (HER2) status in gastric cancer patients. METHODS The raw enhanced CT image dataset consisted of CT images of 389 patients in the retrospective cohort, The Cancer Imaging Archive (TCIA) cohort, and the prospective cohort. DLS was developed by transfer learning for tumor detection, staging, and HER2 status prediction. The pre-trained Yolov5, EfficientNet, EfficientNetV2, Vision Transformer (VIT), and Swin Transformer (SWT) were studied. The tumor detection and staging dataset consisted of 4860 enhanced CT images and annotated tumor bounding boxes. The HER2 state prediction dataset consisted of 38900 enhanced CT images. RESULTS The DetectionNet based on Yolov5 realized tumor detection and staging and achieved a mean Average Precision (IoU=0.5) (mAP_0.5) of 0.909 in the external validation cohort. The VIT-based PredictionNet performed optimally in HER2 status prediction with the area under the receiver operating characteristics curve (AUC) of 0.9721 and 0.9995 in the TCIA cohort and prospective cohort, respectively. DLS included DetectionNet and PredictionNet had shown excellent performance in CT image interpretation. CONCLUSION This study developed the enhanced CT-based DLS to preoperatively predict the stage and HER2 status of gastric cancer patients, which will help in choosing the appropriate treatment to improve the survival of gastric cancer patients.
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Affiliation(s)
| | | | - Jianping Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Xie W, Jiang Z, Zhou X, Zhang X, Zhang M, Liu R, Zheng L, Xin F, Lu Y, Wang D. Quantitative Radiological Features and Deep Learning for the Non-Invasive Evaluation of Programmed Death Ligand 1 Expression Levels in Gastric Cancer Patients: A Digital Bopsy Study. Acad Radiol 2022:S1076-6332(22)00549-9. [DOI: 10.1016/j.acra.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
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Zeng Q, Zhu Y, Li L, Feng Z, Shu X, Wu A, Luo L, Cao Y, Tu Y, Xiong J, Zhou F, Li Z. CT-based radiomic nomogram for preoperative prediction of DNA mismatch repair deficiency in gastric cancer. Front Oncol 2022; 12:883109. [PMID: 36185292 PMCID: PMC9523515 DOI: 10.3389/fonc.2022.883109] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDNA mismatch repair (MMR) deficiency has attracted considerable attention as a predictor of the immunotherapy efficacy of solid tumors, including gastric cancer. We aimed to develop and validate a computed tomography (CT)-based radiomic nomogram for the preoperative prediction of MMR deficiency in gastric cancer (GC).MethodsIn this retrospective analysis, 225 and 91 GC patients from two distinct hospital cohorts were included. Cohort 1 was randomly divided into a training cohort (n = 176) and an internal validation cohort (n = 76), whereas cohort 2 was considered an external validation cohort. Based on repeatable radiomic features, a radiomic signature was constructed using the least absolute shrinkage and selection operator (LASSO) regression analysis. We employed multivariable logistic regression analysis to build a radiomics-based model based on radiomic features and preoperative clinical characteristics. Furthermore, this prediction model was presented as a radiomic nomogram, which was evaluated in the training, internal validation, and external validation cohorts.ResultsThe radiomic signature composed of 15 robust features showed a significant association with MMR protein status in the training, internal validation, and external validation cohorts (both P-values <0.001). A radiomic nomogram incorporating a radiomic signature and two clinical characteristics (age and CT-reported N stage) represented good discrimination in the training cohort with an AUC of 0.902 (95% CI: 0.853–0.951), in the internal validation cohort with an AUC of 0.972 (95% CI: 0.945–1.000) and in the external validation cohort with an AUC of 0.891 (95% CI: 0.825–0.958).ConclusionThe CT-based radiomic nomogram showed good performance for preoperative prediction of MMR protein status in GC. Furthermore, this model was a noninvasive tool to predict MMR protein status and guide neoadjuvant therapy.
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Affiliation(s)
- Qingwen Zeng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yanyan Zhu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Leyan Li
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Zongfeng Feng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xufeng Shu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Ahao Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Lianghua Luo
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Yi Cao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
- *Correspondence: Zhengrong Li, ; Yi Cao,
| | - Yi Tu
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianbo Xiong
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Zhengrong Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang, China
- Institute of Digestive Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Zhengrong Li, ; Yi Cao,
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11
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Xu M, Liu S, Li L, Qiao X, Ji C, Tan L, Zhou Z. Development and validation of multivariate models integrating preoperative clinicopathological and radiographic findings to predict HER2 status in gastric cancer. Sci Rep 2022; 12:14177. [PMID: 35986169 PMCID: PMC9391326 DOI: 10.1038/s41598-022-18433-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022] Open
Abstract
The combination of trastuzumab and chemotherapy is recommended as first-line therapy for patients with human epidermal growth factor receptor 2 (HER2) positive advanced gastric cancers (GCs). Successful trastuzumab-induced targeted therapy should be based on the assessment of HER2 overexpression. This study aimed to evaluate the feasibility of multivariate models based on hematological parameters, endoscopic biopsy, and computed tomography (CT) findings for assessing HER2 overexpression in GC. This retrospective study included 183 patients with GC, and they were divided into primary (n = 137) and validation (n = 46) cohorts at a ratio of 3:1. Hematological parameters, endoscopic biopsy, CT morphological characteristics, and CT value-related and texture parameters of all patients were collected and analyzed. The mean corpuscular hemoglobin concentration value, morphological type, 3 CT value-related parameters, and 22 texture parameters in three contrast-enhanced phases differed significantly between the two groups (all p < 0.05). Multivariate models based on the regression analysis and support vector machine algorithm achieved areas under the curve of 0.818 and 0.879 in the primary cohort, respectively. The combination of hematological parameters, CT morphological characteristics, CT value-related and texture parameters could predict HER2 overexpression in GCs with satisfactory diagnostic efficiency. The decision curve analysis confirmed the clinical utility.
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Affiliation(s)
- Mengying Xu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Lin Li
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Xiangmei Qiao
- Department of Ultrasound, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China
| | - Changfeng Ji
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Lingyu Tan
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, 210008, Jiangsu, China
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No.321, Zhongshan Road, Nanjing, 210008, Jiangsu, China.
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12
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Tian R, Li Y, Jia C, Mou Y, Zhang H, Wu X, Li J, Yu G, Mao N, Song X. Radiomics Model for Predicting TP53 Status Using CT and Machine Learning Approach in Laryngeal Squamous Cell Carcinoma. Front Oncol 2022; 12:823428. [PMID: 35574352 PMCID: PMC9095903 DOI: 10.3389/fonc.2022.823428] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/04/2022] [Indexed: 11/16/2022] Open
Abstract
Objective We aim to establish and validate computed tomography (CT)-based radiomics model for predicting TP53 status in patients with laryngeal squamous cell carcinoma (LSCC). Methods We divided all patients into a training set 1 (n=66) and a testing set 1 (n=30) to establish and validate radiomics model to predict TP53. Radiomics features were selected by analysis of variance (ANOVA) and the least absolute shrinkage and selection operator (Lasso) regression analysis. Five radiomics models were established by using K-Nearest Neighbor, logistics regressive, linear-support vector machine (SVM), gaussian-SVM, and polynomial-SVM in training set 1. We also divided all patients into a training set 2 and a testing set 2 according to different CT equipment to establish and evaluate the stability of the radiomics models. Results After ANOVA and subsequent Lasso regression analysis, 22 radiomics features were selected to build the radiomics model in training set 1. The radiomics model based on linear-SVM has the best predictive performance of the five models, and the area under the receiver operating characteristic curve in training set 1 and testing set 1 were 0.831(95% confidence interval [CI] 0.692–0.970) and 0.797(95% CI 0.632–0.957) respectively. The specificity, sensitivity, and accuracy were 0.971(95% CI 0.834–0.999), 0.714(95% CI 0.535–0.848), and 0.843(95% CI 0.657–0.928) in training set 1 and 0.750(95% CI 0.500–0.938), 0.786(95% CI 0.571–1.000), and 0.667(95% CI 0.467–0.720) in testing set 1, respectively. In addition, the radiomics model also achieved stable prediction results even in different CT equipment. Decision curve analysis showed that the radiomics model for predicting TP53 status could benefit LSCC patients. Conclusion We developed and validated a relatively optimal radiomics model for TP53 status prediction by trying five different machine learning methods in patients with LSCC. It shown great potential of radiomics features for predicting TP53 status preoperatively and guiding clinical treatment.
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Affiliation(s)
- Ruxian Tian
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yumei Li
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Chuanliang Jia
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yakui Mou
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Haicheng Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Xinxin Wu
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jingjing Li
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Guohua Yu
- Department of Pathology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Xicheng Song
- Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.,Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, China
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13
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Song R, Cui Y, Ren J, Zhang J, Yang Z, Li D, Li Z, Yang X. CT-based radiomics analysis in the prediction of response to neoadjuvant chemotherapy in locally advanced gastric cancer: A dual-center study. Radiother Oncol 2022; 171:155-163. [DOI: 10.1016/j.radonc.2022.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/26/2022] [Accepted: 04/21/2022] [Indexed: 12/24/2022]
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王 寅, 雷 大. [Research progress in CT-based radiomics constructing hypopharyngeal cancer and multisystem tumor prediction model]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:158-162. [PMID: 35172558 PMCID: PMC10128304 DOI: 10.13201/j.issn.2096-7993.2022.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Indexed: 04/30/2023]
Abstract
Radiomics, a technique for quantitative analysis of tumor imaging information through high-throughput extraction, uses a non-invasive way to capture a large number of internal heterogeneity characteristics of tumors, providing imaging basis for tumor staging and typing, tumor invasion site and distant metastasis, postoperative induction chemotherapy and prognosis, and providing new ideas and new thinking for the field of personalized precision medicine of tumors. This review aims to briefly summarize the latest research progress of imaging omics in the diagnosis and treatment design of head and neck tumor, and to discuss the research progress of constructing the treatment plan and prognosis evaluation model of hypopharyngeal cancer based on imaging omics, and to predict and forecast its development direction and clinical application.
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Affiliation(s)
- 寅 王
- 山东大学齐鲁医院耳鼻咽喉科 国家卫健委耳鼻喉科学重点实验室(济南,250000)
| | - 大鹏 雷
- 山东大学齐鲁医院耳鼻咽喉科 国家卫健委耳鼻喉科学重点实验室(济南,250000)
- 雷大鹏,
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15
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Wang S, Chen Y, Zhang H, Liang Z, Bu J. The Value of Predicting Human Epidermal Growth Factor Receptor 2 Status in Adenocarcinoma of the Esophagogastric Junction on CT-Based Radiomics Nomogram. Front Oncol 2021; 11:707686. [PMID: 34722254 PMCID: PMC8552039 DOI: 10.3389/fonc.2021.707686] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose We developed and validated a CT-based radiomics nomogram to predict HER2 status in patients with adenocarcinoma of esophagogastric junction (AEG). Method A total of 101 patients with HER2-positive (n=46) and HER2-negative (n=55) esophagogastric junction adenocarcinoma (AEG) were retrospectively analyzed. They were then randomly divided into a training cohort (n=70) and a verification cohort (n=31). The radiomics features were obtained from the portal phase of the CT enhanced scan. We used the least absolute shrinkage and selection operator (LASSO) logistic regression method to select the best radiomics features in the training cohort, combined them linearly, and used the radiomics signature formula to calculate the radiomics score (Rad-score) of each AEG patient. A multivariable logistic regression method was applied to develop a prediction model that incorporated the radiomics signature and independent risk predictors. The prediction performance of the nomogram was evaluated using the training and validation cohorts. Result In the training (P<0.001) and verification groups (P<0.001), the radiomics signature combined with seven radiomics features was significantly correlated with HER2 status. The nomogram composed of CT-reported T stage and radiomics signature showed very good predictive performance for HER2 status. The area under the curve (AUC) of the training cohort was 0.946 (95% CI: 0.919–0.973), and that of the validation group was 0.903 (95% CI: 0.847–0.959). The calibration curve of the radiomics nomogram showed a good degree of calibration. Decision-curve analysis revealed that the radiomics nomogram was useful. Conclusion The nomogram CT-based radiomics signature combined with CT-reported T stage can better predict the HER2 status of AEG before surgery. It can be used as a non-invasive prediction tool for HER2 status and is expected to guide clinical treatment decisions in clinical practice, and it can assist in the formulation of individualized treatment plans.
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Affiliation(s)
- Shuxing Wang
- Department of Radiology, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangdong, China
| | - Yiqing Chen
- Department of Radiology, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangdong, China
| | - Han Zhang
- Department of Radiology, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangdong, China
| | - Zhiping Liang
- Department of Radiology, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangdong, China
| | - Jun Bu
- Department of Radiology, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangdong, China
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La Greca Saint-Esteven A, Vuong D, Tschanz F, van Timmeren JE, Dal Bello R, Waller V, Pruschy M, Guckenberger M, Tanadini-Lang S. Systematic Review on the Association of Radiomics with Tumor Biological Endpoints. Cancers (Basel) 2021; 13:cancers13123015. [PMID: 34208595 PMCID: PMC8234501 DOI: 10.3390/cancers13123015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/23/2022] Open
Abstract
Radiomics supposes an alternative non-invasive tumor characterization tool, which has experienced increased interest with the advent of more powerful computers and more sophisticated machine learning algorithms. Nonetheless, the incorporation of radiomics in cancer clinical-decision support systems still necessitates a thorough analysis of its relationship with tumor biology. Herein, we present a systematic review focusing on the clinical evidence of radiomics as a surrogate method for tumor molecular profile characterization. An extensive literature review was conducted in PubMed, including papers on radiomics and a selected set of clinically relevant and commonly used tumor molecular markers. We summarized our findings based on different cancer entities, additionally evaluating the effect of different modalities for the prediction of biomarkers at each tumor site. Results suggest the existence of an association between the studied biomarkers and radiomics from different modalities and different tumor sites, even though a larger number of multi-center studies are required to further validate the reported outcomes.
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Affiliation(s)
- Agustina La Greca Saint-Esteven
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
- Correspondence:
| | - Diem Vuong
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Fabienne Tschanz
- Laboratory of Applied Radiobiology, Department of Radiation Oncology, University of Zurich, 8091 Zurich, Switzerland; (F.T.); (V.W.); (M.P.)
| | - Janita E. van Timmeren
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Riccardo Dal Bello
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Verena Waller
- Laboratory of Applied Radiobiology, Department of Radiation Oncology, University of Zurich, 8091 Zurich, Switzerland; (F.T.); (V.W.); (M.P.)
| | - Martin Pruschy
- Laboratory of Applied Radiobiology, Department of Radiation Oncology, University of Zurich, 8091 Zurich, Switzerland; (F.T.); (V.W.); (M.P.)
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
| | - Stephanie Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, 8091 Zurich, Switzerland; (D.V.); (J.E.v.T.); (R.D.B.); (M.G.); (S.T.-L.)
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Song L, Li C, Yin J. Texture Analysis Using Semiquantitative Kinetic Parameter Maps from DCE-MRI: Preoperative Prediction of HER2 Status in Breast Cancer. Front Oncol 2021; 11:675160. [PMID: 34168994 PMCID: PMC8217832 DOI: 10.3389/fonc.2021.675160] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/14/2021] [Indexed: 12/29/2022] Open
Abstract
Objective To evaluate whether texture features derived from semiquantitative kinetic parameter maps based on breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can determine human epidermal growth factor receptor 2 (HER2) status of patients with breast cancer. Materials and Methods This study included 102 patients with histologically confirmed breast cancer, all of whom underwent preoperative breast DCE-MRI and were enrolled retrospectively. This cohort included 48 HER2-positive cases and 54 HER2-negative cases. Seven semiquantitative kinetic parameter maps were calculated on the lesion area. A total of 55 texture features were extracted from each kinetic parameter map. Patients were randomly divided into training (n = 72) and test (n = 30) sets. The least absolute shrinkage and selection operator (LASSO) was used to select features in the training set, and then, multivariate logistic regression analysis was conducted to establish the prediction models. The classification performance was evaluated by receiver operating characteristic (ROC) analysis. Results Among the seven prediction models, the model with features extracted from the early signal enhancement ratio (ESER) map yielded an area under the ROC curve (AUC) of 0.83 in the training set (sensitivity of 70.59%, specificity of 92.11%, and accuracy of 81.94%), and the highest AUC of 0.83 in the test set (sensitivity of 57.14%, specificity of 100.00%, and accuracy of 80.00%). The model with features extracted from the slope of signal intensity (SIslope) map yielded the highest AUC of 0.92 in the training set (sensitivity of 82.35%, specificity of 97.37%, and accuracy of 90.28%), and an AUC of 0.79 in the test set (sensitivity of 92.86%, specificity of 68.75%, and accuracy of 80.00%). Conclusions Texture features derived from kinetic parameter maps, calculated based on breast DCE-MRI, have the potential to be used as imaging biomarkers to distinguish HER2-positive and HER2-negative breast cancer.
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Affiliation(s)
- Lirong Song
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chunli Li
- Department of Biomedical Engineering, School of Fundamental Sciences, China Medical University, Shenyang, China
| | - Jiandong Yin
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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Ao S, Wang Y, Song Q, Ye Y, Lyu G. Current status and future perspectives on neoadjuvant therapy in gastric cancer. Chin J Cancer Res 2021; 33:181-192. [PMID: 34158738 PMCID: PMC8181872 DOI: 10.21147/j.issn.1000-9604.2021.02.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022] Open
Abstract
Gastric cancer, with high morbidity and mortality rates, is one of the most heterogeneous tumors. Radical gastrectomy and postoperative chemotherapy are the standard treatments. However, the safety and efficacy of neoadjuvant therapy (NAT) need to be confirmed by many trials before implementation, creating a bottleneck in development. Although clinical benefits of NAT have been observed, a series of problems remain to be solved. Before therapy, more contributing factors should be offered for choice in the intended population and ideal regimens. Enhanced computed tomography (CT) scanning is usually applied to evaluate effectiveness according to Response Evaluation Criteria in Solid Tumors (RECIST), yet CT scanning results sometimes differ from pathological responses. After NAT, the appropriate time for surgery is still empirically defined. Our review aims to discuss the abovementioned issues regarding NAT for GC, including indications, selection of regimens, lesion assessment and NAT-surgery interval time.
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Affiliation(s)
- Sheng Ao
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518000, China
- Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing 100044, China
| | - Yuchen Wang
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Qingzhi Song
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518000, China
| | - Yingjiang Ye
- Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing 100044, China
| | - Guoqing Lyu
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen 518000, China
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Wang R, Liu H, Liang P, Zhao H, Li L, Gao J. Radiomics analysis of CT imaging for differentiating gastric neuroendocrine carcinomas from gastric adenocarcinomas. Eur J Radiol 2021; 138:109662. [PMID: 33774440 DOI: 10.1016/j.ejrad.2021.109662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/29/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE To develop and evaluate a CT-based radiomics nomogram for differentiating gastric neuroendocrine carcinomas (NECs) from gastric adenocarcinomas (ADCs). METHODS CT images of 63 patients with gastric NECs were collected retrospectively, and 63 patients with gastric ADCs were selected as the control group. Univariate analysis was used to identify the significant factors of clinical characteristics and CT findings for differentiating gastric NECs from ADCs. Radiomics analysis was applied to CT images of unenhanced, arterial phase and venous phase, respectively. A radiomics nomogram incorporating the radiomics signature and the subjective CT findings was developed and its diagnostic ability was evaluated. The diagnostic performances of CT findings model, radiomics signature and radiomics nomogram were compared using DeLong test. RESULTS The tumor margin and lymph node (LN) metastasis were independent predictors for differentiating gastric NECs from ADCs. The radiomics signature based on venous phase presented superior AUC of 0.798 [95 % confidence interval (CI), 0.657-0.938] in validation cohort. The nomogram incorporated the radiomics signature, tumor margin and LN metastasis showed AUCs of 0.821 (95 %CI: 0.725-0.895) in the primary cohort and 0.809 (95 %CI: 0.649-0.918) in the validation cohort. Moreover, the radiomics nomogram showed good discrimination and calibration. The diagnostic performance of CT findings model was significantly lower than that of radiomics nomogram (p = 0.001) and radiomics signature (p = 0.025). CONCLUSIONS Radiomics analysis exhibited good performance in differentiating gastric NECs from ADCs, and the radiomics nomogram may have significant clinical implications on preoperative detection of gastric malignant tumors.
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Affiliation(s)
- Rui Wang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Huan Liu
- Advanced Application Team, GE Healthcare, Shanghai, 201203, China
| | - Pan Liang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Huiping Zhao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Liming Li
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Jianbo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
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