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Deng B, Wang Q, Liu Y, Yang Y, Gao X, Dai H. A nomogram based on MRI radiomics features of mesorectal fat for diagnosing T2- and T3-stage rectal cancer. Abdom Radiol (NY) 2024; 49:1850-1860. [PMID: 38349392 DOI: 10.1007/s00261-023-04164-w] [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: 07/21/2023] [Revised: 12/10/2023] [Accepted: 12/16/2023] [Indexed: 06/29/2024]
Abstract
PURPOSE To develop and validate a nomogram for the preoperative diagnosis of T2 and T3 stage rectal cancer using MRI radiomics features of mesorectal fat. METHODS The data of 288 patients with T2 and T3 stage rectal cancer were retrospectively collected. Radiomics features were extracted from the lesion region of interest (ROI) in the MRI high-resolution T2WI, apparent diffusion coefficient (ADC), and diffusion-weighted imaging (DWI) sequences. After using ICC inter-group consistency analysis and Pearson correlation analysis to reduce dimensions, LASSO regression analysis was performed to select features and calculate Rad-score for each sequence. Then, Combined_Radscore and nomogram were constructed based on the LASSO-selected features and clinical data for each sequence. Receiver operating characteristic curve (ROC) area under the curve (AUC) was used to evaluate the performance of the Rad-score model and nomogram. Decision curve analysis (DCA) was performed to evaluate the clinical usability of the radiomics nomogram, which were combined with calibration curves to evaluate the prediction accuracy. RESULTS The nomogram based on MRI-report T status and Combined_Radscore achieved AUCs of 0.921 and 0.889 in the training and validation cohorts, respectively. CONCLUSION The nomogram can be stated that the radiomics nomogram based on multi-sequence MRI imaging of the mesorectal fat has excellent diagnosing performance for preoperative differentiation of T2 and T3 stage rectal cancer.
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Affiliation(s)
- Bo Deng
- Department of Radiology, Shanghai Fifth Rehabilitation Hospital, Shanghai, China
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qian Wang
- Department of Radiology, Shanghai Fifth Rehabilitation Hospital, Shanghai, China
| | - Yuanqing Liu
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yanwei Yang
- Magnetic Resonance Room of Orthopedics Department, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaolong Gao
- Department of Radiology, Luodian Hospital, Shanghai University Medical College, Baoshan District, Shanghai, China.
| | - Hui Dai
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, China.
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Lu W, Tan X, Zhong Y, Wang P, Ge Y, Zhang H, Hu S. Spectral CT in the evaluation of perineural invasion status in rectal cancer. Jpn J Radiol 2024:10.1007/s11604-024-01575-7. [PMID: 38709434 DOI: 10.1007/s11604-024-01575-7] [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: 12/04/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To investigate whether preoperative spectral CT quantitative parameters can assess perineural invasion (PNI) status in rectal cancer. METHODS Sixty-two patients diagnosed with rectal cancer who underwent preoperative spectral CT were retrospectively enrolled and divided into positive and negative PNI groups according to histopathologic results. The CT attenuation value (HU) of virtual monochromatic images (40-70 keV), spectral curve slope (K(HU)), effective atomic number (Zeff), and iodine concentration (IC) from spectral CT were compared between these two groups using t test or rank sum test. A nomogram was established by incorporating the independent predictors to assess the overall diagnostic efficacy. The area under the ROC curves (AUCs) were compared using the DeLong test. RESULTS The preoperative spectral CT parameters (40-70 keV attenuation, K(HU), Zeff, and IC) were significantly higher in the PNI-positive group compared to the PNI-negative group (all p < 0.05). The highest predictive efficiency of PNI was observed at 40 keV attenuation, with an area under the curve (AUC), sensitivity, specificity, and accuracy of 0.847, 81.8%, 72.5%, and 75.8%, respectively. Binary logistic regression demonstrated that the clinical feature (cN stage) and 40 keV attenuation were independent predictors of PNI status. The nomogram incorporating these two predictors (cN stage and 40 keV attenuation) exhibited the best evaluation efficacy, with an AUC, sensitivity, specificity, and accuracy of 0.885, 86.4%, 77.5%, and 80.6%. CONCLUSION Spectral CT quantitative parameters proved valuable in the preoperative assessment of PNI status in rectal cancer patients. The combination of spectral CT parameters and clinical features could further enhance the diagnostic efficiency.
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Affiliation(s)
- Wenzheng Lu
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Xiaoying Tan
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Yanqi Zhong
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Peng Wang
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Yuxi Ge
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Heng Zhang
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Shudong Hu
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China.
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Liu Y, Sun BJT, Zhang C, Li B, Yu XX, Du Y. Preoperative prediction of perineural invasion of rectal cancer based on a magnetic resonance imaging radiomics model: A dual-center study. World J Gastroenterol 2024; 30:2233-2248. [PMID: 38690027 PMCID: PMC11056922 DOI: 10.3748/wjg.v30.i16.2233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/08/2024] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Perineural invasion (PNI) has been used as an important pathological indicator and independent prognostic factor for patients with rectal cancer (RC). Preoperative prediction of PNI status is helpful for individualized treatment of RC. Recently, several radiomics studies have been used to predict the PNI status in RC, demonstrating a good predictive effect, but the results lacked generalizability. The preoperative prediction of PNI status is still challenging and needs further study. AIM To establish and validate an optimal radiomics model for predicting PNI status preoperatively in RC patients. METHODS This retrospective study enrolled 244 postoperative patients with pathologically confirmed RC from two independent centers. The patients underwent pre-operative high-resolution magnetic resonance imaging (MRI) between May 2019 and August 2022. Quantitative radiomics features were extracted and selected from oblique axial T2-weighted imaging (T2WI) and contrast-enhanced T1WI (T1CE) sequences. The radiomics signatures were constructed using logistic regression analysis and the predictive potential of various sequences was compared (T2WI, T1CE and T2WI + T1CE fusion sequences). A clinical-radiomics (CR) model was established by combining the radiomics features and clinical risk factors. The internal and external validation groups were used to validate the proposed models. The area under the receiver operating characteristic curve (AUC), DeLong test, net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration curve, and decision curve analysis (DCA) were used to evaluate the model performance. RESULTS Among the radiomics models, the T2WI + T1CE fusion sequences model showed the best predictive performance, in the training and internal validation groups, the AUCs of the fusion sequence model were 0.839 [95% confidence interval (CI): 0.757-0.921] and 0.787 (95%CI: 0.650-0.923), which were higher than those of the T2WI and T1CE sequence models. The CR model constructed by combining clinical risk factors had the best predictive performance. In the training and internal and external validation groups, the AUCs of the CR model were 0.889 (95%CI: 0.824-0.954), 0.889 (95%CI: 0.803-0.976) and 0.894 (95%CI: 0.814-0.974). Delong test, NRI, and IDI showed that the CR model had significant differences from other models (P < 0.05). Calibration curves demonstrated good agreement, and DCA revealed significant benefits of the CR model. CONCLUSION The CR model based on preoperative MRI radiomics features and clinical risk factors can preoperatively predict the PNI status of RC noninvasively, which facilitates individualized treatment of RC patients.
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Affiliation(s)
- Yan Liu
- Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Bai-Jin-Tao Sun
- Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Chuan Zhang
- Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Bing Li
- Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Xuan Yu
- Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Yong Du
- Department of Radiology, The Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
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Liu NJ, Liu MS, Tian W, Zhai YN, Lv WL, Wang T, Guo SL. The value of machine learning based on CT radiomics in the preoperative identification of peripheral nerve invasion in colorectal cancer: a two-center study. Insights Imaging 2024; 15:101. [PMID: 38578423 PMCID: PMC10997560 DOI: 10.1186/s13244-024-01664-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND We aimed to explore the application value of various machine learning (ML) algorithms based on multicenter CT radiomics in identifying peripheral nerve invasion (PNI) of colorectal cancer (CRC). METHODS A total of 268 patients with colorectal cancer who underwent CT examination in two hospitals from January 2016 to December 2022 were considered. Imaging and clinicopathological data were collected through the Picture Archiving and Communication System (PACS). The Feature Explorer software (FAE) was used to identify the peripheral nerve invasion of colorectal patients in center 1, and the best feature selection and classification channels were selected. Finally, the best feature selection and classifier pipeline were verified in center 2. RESULTS The six-feature models using RFE feature selection and GP classifier had the highest AUC values, which were 0.610, 0.699, and 0.640, respectively. FAE generated a more concise model based on one feature (wavelet-HLL-glszm-LargeAreaHighGrayLevelEmphasis) and achieved AUC values of 0.614 and 0.663 on the validation and test sets, respectively, using the "one standard error" rule. Using ANOVA feature selection, the GP classifier had the best AUC value in a one-feature model, with AUC values of 0.611, 0.663, and 0.643 on the validation, internal test, and external test sets, respectively. Similarly, when using the "one standard error" rule, the model based on one feature (wave-let-HLL-glszm-LargeAreaHighGrayLevelEmphasis) achieved AUC values of 0.614 and 0.663 on the validation and test sets, respectively. CONCLUSIONS Combining artificial intelligence and radiomics features is a promising approach for identifying peripheral nerve invasion in colorectal cancer. This innovative technique holds significant potential for clinical medicine, offering broader application prospects in the field. CRITICAL RELEVANCE STATEMENT The multi-channel ML method based on CT radiomics has a simple operation process and can be used to assist in the clinical screening of patients with CRC accompanied by PNI. KEY POINTS • Multi-channel ML in the identification of peripheral nerve invasion in CRC. • Multi-channel ML method based on CT-radiomics can detect the PNI of CRC. • Early preoperative identification of PNI in CRC is helpful to improve the formulation of treatment strategies and the prognosis of patients.
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Affiliation(s)
- Nian-Jun Liu
- The First School of Clinical Medical, Lanzhou University, LanzhouGansu, 73000, China
- Department of Radiology, the First Hospital of Lanzhou University, LanzhouGansu, 73000, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, LanzhouGansu, 73000, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, LanzhouGansu, 73000, China
- Gansu Province clinical research center for radiology imaging, LanzhouGansu, 73000, China
| | - Mao-Sen Liu
- Lichuan People's Hospital, Lichuan, 445400, Hubei, China
| | - Wei Tian
- The First School of Clinical Medical, Lanzhou University, LanzhouGansu, 73000, China
- Department of Radiology, the First Hospital of Lanzhou University, LanzhouGansu, 73000, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, LanzhouGansu, 73000, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, LanzhouGansu, 73000, China
- Gansu Province clinical research center for radiology imaging, LanzhouGansu, 73000, China
| | - Ya-Nan Zhai
- The First School of Clinical Medical, Lanzhou University, LanzhouGansu, 73000, China
- Department of Radiology, the First Hospital of Lanzhou University, LanzhouGansu, 73000, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, LanzhouGansu, 73000, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, LanzhouGansu, 73000, China
- Gansu Province clinical research center for radiology imaging, LanzhouGansu, 73000, China
| | - Wei-Long Lv
- The First School of Clinical Medical, Lanzhou University, LanzhouGansu, 73000, China
- Department of Radiology, the First Hospital of Lanzhou University, LanzhouGansu, 73000, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, LanzhouGansu, 73000, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, LanzhouGansu, 73000, China
- Gansu Province clinical research center for radiology imaging, LanzhouGansu, 73000, China
| | - Tong Wang
- The First School of Clinical Medical, Lanzhou University, LanzhouGansu, 73000, China
- Department of Radiology, the First Hospital of Lanzhou University, LanzhouGansu, 73000, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, LanzhouGansu, 73000, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, LanzhouGansu, 73000, China
- Gansu Province clinical research center for radiology imaging, LanzhouGansu, 73000, China
| | - Shun-Lin Guo
- The First School of Clinical Medical, Lanzhou University, LanzhouGansu, 73000, China.
- Department of Radiology, the First Hospital of Lanzhou University, LanzhouGansu, 73000, China.
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, LanzhouGansu, 73000, China.
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, LanzhouGansu, 73000, China.
- Gansu Province clinical research center for radiology imaging, LanzhouGansu, 73000, China.
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Mottola M, Golfieri R, Bevilacqua A. The Effectiveness of an Adaptive Method to Analyse the Transition between Tumour and Peritumour for Answering Two Clinical Questions in Cancer Imaging. SENSORS (BASEL, SWITZERLAND) 2024; 24:1156. [PMID: 38400314 PMCID: PMC10893370 DOI: 10.3390/s24041156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
Based on the well-known role of peritumour characterization in cancer imaging to improve the early diagnosis and timeliness of clinical decisions, this study innovated a state-of-the-art approach for peritumour analysis, mainly relying on extending tumour segmentation by a predefined fixed size. We present a novel, adaptive method to investigate the zone of transition, bestriding tumour and peritumour, thought of as an annular-like shaped area, and detected by analysing gradient variations along tumour edges. For method validation, we applied it on two datasets (hepatocellular carcinoma and locally advanced rectal cancer) imaged by different modalities and exploited the zone of transition regions as well as the peritumour ones derived by adopting the literature approach for building predictive models. To measure the zone of transition's benefits, we compared the predictivity of models relying on both "standard" and novel peritumour regions. The main comparison metrics were informedness, specificity and sensitivity. As regards hepatocellular carcinoma, having circular and regular shape, all models showed similar performance (informedness = 0.69, sensitivity = 84%, specificity = 85%). As regards locally advanced rectal cancer, with jagged contours, the zone of transition led to the best informedness of 0.68 (sensitivity = 89%, specificity = 79%). The zone of transition advantages include detecting the peritumour adaptively, even when not visually noticeable, and minimizing the risk (higher in the literature approach) of including adjacent diverse structures, which was clearly highlighted during image gradient analysis.
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Affiliation(s)
- Margherita Mottola
- Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, 40126 Bologna, Italy;
| | - Rita Golfieri
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy;
| | - Alessandro Bevilacqua
- Department of Computer Science and Engineering (DISI), University of Bologna, 40126 Bologna, Italy
- Advanced Research Center on Electronic Systems (ARCES), University of Bologna, 40125 Bologna, Italy
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Liu WX, Wu H, Cai C, Lai QQ, Wang Y, Li YZ. Research on automatic recognition radiomics algorithm for early sacroiliac arthritis based on sacroiliac MRI imaging. J Orthop Surg Res 2024; 19:96. [PMID: 38287422 PMCID: PMC10826273 DOI: 10.1186/s13018-024-04569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/16/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVE To create an automated machine learning model using sacroiliac joint MRI imaging for early sacroiliac arthritis detection, aiming to enhance diagnostic accuracy. METHODS We conducted a retrospective analysis involving 71 patients with early sacroiliac arthritis and 85 patients with normal sacroiliac joint MRI scans. Transverse T1WI and T2WI sequences were collected and subjected to radiomics analysis by two physicians. Patients were randomly divided into training and test groups at a 7:3 ratio. Initially, we extracted the region of interest on the sacroiliac joint surface using ITK-SNAP 3.6.0 software and extracted radiomic features. We retained features with an Intraclass Correlation Coefficient > 0.80, followed by filtering using max-relevance and min-redundancy (mRMR) and LASSO algorithms to establish an automatic identification model for sacroiliac joint surface injury. Receiver operating characteristic (ROC) curves were plotted, and the area under the ROC curve (AUC) was calculated. Model performance was assessed by accuracy, sensitivity, and specificity. RESULTS We evaluated model performance, achieving an AUC of 0.943 for the SVM-T1WI training group, with accuracy, sensitivity, and specificity values of 0.878, 0.836, and 0.943, respectively. The SVM-T1WI test group exhibited an AUC of 0.875, with corresponding accuracy, sensitivity, and specificity values of 0.909, 0.929, and 0.875, respectively. For the SVM-T2WI training group, the AUC was 0.975, with accuracy, sensitivity, and specificity values of 0.933, 0.889, and 0.750. The SVM-T2WI test group produced an AUC of 0.902, with accuracy, sensitivity, and specificity values of 0.864, 0.889, and 0.800. In the SVM-bimodal training group, we achieved an AUC of 0.974, with accuracy, sensitivity, and specificity values of 0.921, 0.889, and 0.971, respectively. The SVM-bimodal test group exhibited an AUC of 0.964, with accuracy, sensitivity, and specificity values of 0.955, 1.000, and 0.875, respectively. CONCLUSION The radiomics-based detection model demonstrates excellent automatic identification performance for early sacroiliitis.
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Affiliation(s)
- Wen-Xi Liu
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, 362000, China
| | - Hong Wu
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, 362000, China
| | - Chi Cai
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, 362000, China
| | - Qing-Quan Lai
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, 362000, China
| | - Yi Wang
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, 362000, China.
| | - Yuan-Zhe Li
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan North Road, Quanzhou, 362000, China.
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Miranda J, Horvat N, Araujo-Filho JAB, Albuquerque KS, Charbel C, Trindade BMC, Cardoso DL, de Padua Gomes de Farias L, Chakraborty J, Nomura CH. The Role of Radiomics in Rectal Cancer. J Gastrointest Cancer 2023; 54:1158-1180. [PMID: 37155130 DOI: 10.1007/s12029-022-00909-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 05/10/2023]
Abstract
PURPOSE Radiomics is a promising method for advancing imaging assessment in rectal cancer. This review aims to describe the emerging role of radiomics in the imaging assessment of rectal cancer, including various applications of radiomics based on CT, MRI, or PET/CT. METHODS We conducted a literature review to highlight the progress of radiomic research to date and the challenges that need to be addressed before radiomics can be implemented clinically. RESULTS The results suggest that radiomics has the potential to provide valuable information for clinical decision-making in rectal cancer. However, there are still challenges in terms of standardization of imaging protocols, feature extraction, and validation of radiomic models. Despite these challenges, radiomics holds great promise for personalized medicine in rectal cancer, with the potential to improve diagnosis, prognosis, and treatment planning. Further research is needed to validate the clinical utility of radiomics and to establish its role in routine clinical practice. CONCLUSION Overall, radiomics has emerged as a powerful tool for improving the imaging assessment of rectal cancer, and its potential benefits should not be underestimated.
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Affiliation(s)
- Joao Miranda
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 29, New York, NY, 10065, USA
| | - Natally Horvat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 29, New York, NY, 10065, USA.
| | - Jose A B Araujo-Filho
- Department of Radiology, Hospital Sirio-Libanes, 91 Adma Jafet, Sao Paulo, SP, 01308-050, Brazil
| | - Kamila S Albuquerque
- Department of Radiology, Hospital Beneficência Portuguesa, 637 Maestro Cardim, Sao Paulo, SP, 01323-001, Brazil
| | - Charlotte Charbel
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 29, New York, NY, 10065, USA
| | - Bruno M C Trindade
- Department of Radiology, University of Sao Paulo, 75 Dr. Ovídio Pires de Campos, Sao Paulo, SP, 05403-010, Brazil
| | - Daniel L Cardoso
- Department of Radiology, Hospital Sirio-Libanes, 91 Adma Jafet, Sao Paulo, SP, 01308-050, Brazil
| | | | - Jayasree Chakraborty
- Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Cesar Higa Nomura
- Department of Radiology, University of Sao Paulo, 75 Dr. Ovídio Pires de Campos, Sao Paulo, SP, 05403-010, Brazil
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Liu J, Sun L, Zhao X, Lu X. Development and validation of a combined nomogram for predicting perineural invasion status in rectal cancer via computed tomography-based radiomics. J Cancer Res Ther 2023; 19:1552-1559. [PMID: 38156921 DOI: 10.4103/jcrt.jcrt_2633_22] [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: 12/15/2022] [Accepted: 07/05/2023] [Indexed: 01/03/2024]
Abstract
AIM This study aimed to create and validate a clinic-radiomics nomogram based on computed tomography (CT) imaging for predicting preoperative perineural invasion (PNI) of rectal cancer (RC). MATERIAL AND METHODS This study enrolled 303 patients with RC who were divided into training (n = 242) and test datasets (n = 61) in an 8:2 ratio with all their clinical outcomes. A total of 3,296 radiomic features were extracted from CT images. Five machine learning (ML) models (logistic regression (LR)/K-nearest neighbor (KNN)/multilayer perceptron (MLP)/support vector machine (SVM)/light gradient boosting machine (LightGBM)) were developed using radiomic features derived from the arterial and venous phase images, and the model with the best diagnostic performance was selected. By combining the radiomics and clinical signatures, a fused nomogram model was constructed. RESULTS After using the Mann-Whitney U-test and least absolute shrinkage and selection operator (LASSO) to remove redundant features, the MLP model proved to be the most efficient among the five ML models. The fusion nomogram based on MLP prediction probability further improves the ability to predict the PNI status. The area under the curve (AUC) of the training and test sets was 0.883 and 0.889, respectively, which were higher than those of the clinical (training set, AUC = 0.710; test set, AUC = 0.762) and radiomic models (training set, AUC = 0.840; test set, AUC = 0.834). CONCLUSIONS The clinical-radiomics combined nomogram model based on enhanced CT images efficiently predicted the PNI status of patients with RC.
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Affiliation(s)
- Jiaxuan Liu
- Department of Radiology, The Fourth Affiliated Hospital of China Medical University, Liaoning, China
| | - Lingling Sun
- Department of Radiology, The Fourth Affiliated Hospital of China Medical University, Liaoning, China
| | - Xiang Zhao
- Institute of Innovative Science and Technology, Shenyang University, Liaoning, China
| | - Xi Lu
- Department of Radiology, The Fourth Affiliated Hospital of China Medical University, Liaoning, China
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Wang J, Zhu X, Zeng J, Liu C, Shen W, Sun X, Lin Q, Fang J, Chen Q, Ji Y. Using clinical and radiomic feature-based machine learning models to predict pathological complete response in patients with esophageal squamous cell carcinoma receiving neoadjuvant chemoradiation. Eur Radiol 2023; 33:8554-8563. [PMID: 37439939 DOI: 10.1007/s00330-023-09884-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/25/2023] [Accepted: 04/22/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE This study aimed to build radiomic feature-based machine learning models to predict pathological clinical response (pCR) of neoadjuvant chemoradiation therapy (nCRT) for esophageal squamous cell carcinoma (ESCC) patients. METHODS A total of 112 ESCC patients who underwent nCRT followed by surgical treatment from January 2008 to December 2018 were recruited. According to pCR status (no visible cancer cells in primary cancer lesion), patients were categorized into primary cancer lesion pCR (ppCR) group (N = 65) and non-ppCR group (N = 47). Patients were also categorized into total pCR (tpCR) group (N = 48) and non-tpCR group (N = 64) according to tpCR status (no visible cancer cells in primary cancer lesion or lymph nodes). Radiomic features of pretreatment CT images were extracted, feature selection was performed, machine learning models were trained to predict ppCR and tpCR, respectively. RESULTS A total of 620 radiomic features were extracted. For ppCR prediction models, radiomic model had an area under the curve (AUC) of 0.817 (95% CI: 0.732-0.896) in the testing set; and the combination model that included rad-score and clinical features had a great predicting performance, with an AUC of 0.891 (95% CI: 0.823-0.950) in the testing set. For tpCR prediction models, radiomic model had an AUC of 0.713 (95% CI: 0.613-0.808) in the testing set; and the combination model also had a great predicting performance, with an AUC of 0.814 (95% CI: 0.728-0.881) in the testing set. CONCLUSION This study built machine learning models for predicting ppCR and tpCR of ESCC patients with favorable predicting performance respectively, which aided treatment plan optimization. CLINICAL RELEVANCE STATEMENT This study significantly improved the predictive value of machine learning models based on radiomic features to accurately predict response to therapy of esophageal squamous cell carcinoma patients after neoadjuvant chemoradiation therapy, providing guidance for further treatment. KEY POINTS • Combination model that included rad-score and clinical features had a great predicting performance. • Primary tumor pCR predicting models exhibit better predicting performance compared to corresponding total pCR predicting models.
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Affiliation(s)
- Jin Wang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
| | - Xiang Zhu
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Jian Zeng
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | | | - Wei Shen
- Philips Healthcare, Shanghai, China
| | - Xiaojiang Sun
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Qingren Lin
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Jun Fang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China
| | - Qixun Chen
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
| | - Yongling Ji
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
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Ren XC, Liang P. Analysis of influencing factors of nerve invasion in locally advanced gastric cancer. Abdom Radiol (NY) 2023; 48:3005-3011. [PMID: 37289214 DOI: 10.1007/s00261-023-03970-6] [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: 03/20/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Accurate preoperative diagnosis of locally advanced gastric cancer (GC) with nerve invasion is very important for guiding the clinical formulation of a reasonable treatment plan, improving treatment efficacy, and improving prognosis. The present study sought to analyze and evaluate the clinicopathological features of locally advanced GC, and to explore the risk factors associated with the state of nerve invasion. METHODS The clinicopathological data of 296 patients with locally advanced GC were retrospectively analyzed in our hospital from July 2011 to December 2020 who underwent radical gastrectomy. PNI is defined as a tumor close to the nerve and involving at least 33% of its circumference or tumor cells within any of the 3 layers of the nerve sheath. The patient's age, gender, tumor location, T stage, N stage, TNM stage, degree of differentiation, Lauren classification, microvascular invasion, as well as TAP, AFP, CEA, CA125, CA199, CA724, CA153, tumor thickness, longest diameter, and plain CT value, arterial phase CT value, venous phase CT value, arterial phase enhancement rate, venous phase enhancement rate were assessed. RESULTS A total of 296 patients with locally advanced GC were included, and 226 (76.35%) were positive for nerve invasion. Univariate analysis showed that tumor T stage, N stage, TNM stage, Lauren classification, tumor thickness, and longest diameter were related to the state of nerve invasion (P < 0.05). Multivariate analysis showed that tumor TNM stage was an independent risk factor for nerve invasion (OR 0.393, 95%CI 0.165-0.939, P = 0.036). CONCLUSIONS Tumor TNM stage is an independent risk factor for nerve invasion (+) in patients with locally advanced GC. Patients at high risk of nerve invasion should be followed closely and, if necessary, performed pathological examinations.
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Affiliation(s)
- Xiu-Chun Ren
- Department of Ultrasonography, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
| | - Pan Liang
- Department of Radiology, The First Affiliated Hospital, Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, 450052, China.
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Qin S, Lu S, Liu K, Zhou Y, Wang Q, Chen Y, Zhang E, Wang H, Lang N. Radiomics from Mesorectal Blood Vessels and Lymph Nodes: A Novel Prognostic Predictor for Rectal Cancer with Neoadjuvant Therapy. Diagnostics (Basel) 2023; 13:1987. [PMID: 37370882 DOI: 10.3390/diagnostics13121987] [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: 04/20/2023] [Revised: 05/24/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
The objective of our study is to investigate the predictive value of various combinations of radiomic features from intratumoral and different peritumoral regions of interest (ROIs) for achieving a good pathological response (pGR) following neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC). This retrospective study was conducted using data from LARC patients who underwent nCRT between 2013 and 2021. Patients were divided into training and validation cohorts at a ratio of 4:1. Intratumoral ROIs (ROIITU) were segmented on T2-weighted imaging, while peritumoral ROIs were segmented using two methods: ROIPTU_2mm, ROIPTU_4mm, and ROIPTU_6mm, obtained by dilating the boundary of ROIITU by 2 mm, 4 mm, and 6 mm, respectively; and ROIMR_F and ROIMR_BVLN, obtained by separating the fat and blood vessels + lymph nodes in the mesorectum. After feature extraction and selection, 12 logistic regression models were established using radiomics features derived from different ROIs or ROI combinations, and five-fold cross-validation was performed. The average area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of the models. The study included 209 patients, consisting of 118 pGR and 91 non-pGR patients. The model that integrated ROIITU and ROIMR_BVLN features demonstrated the highest predictive ability, with an AUC (95% confidence interval) of 0.936 (0.904-0.972) in the training cohort and 0.859 (0.745-0.974) in the validation cohort. This model outperformed models that utilized ROIITU alone (AUC = 0.779), ROIMR_BVLN alone (AUC = 0.758), and other models. The radscore derived from the optimal model can predict the treatment response and prognosis after nCRT. Our findings validated that the integration of intratumoral and peritumoral radiomic features, especially those associated with mesorectal blood vessels and lymph nodes, serves as a potent predictor of pGR to nCRT in patients with LARC. Pending further corroboration in future research, these insights could provide novel imaging markers for refining therapeutic strategies.
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Affiliation(s)
- Siyuan Qin
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Siyi Lu
- Department of General Surgery, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Ke Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Yan Zhou
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Qizheng Wang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Enlong Zhang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
- Department of Radiology, Peking University International Hospital, Life Park Road No. 1 Life Science Park of Zhong Guancun, Chang Ping District, Beijing 102206, China
| | - Hao Wang
- Department of Radiation Oncology, Cancer Center, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
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Can radiomics replace the SPARCC scoring system in evaluating bone marrow edema of sacroiliac joints in patients with axial spondyloarthritis? Clin Rheumatol 2023; 42:1675-1682. [PMID: 36795334 DOI: 10.1007/s10067-023-06543-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES To develop an objective and efficient method based on radiomics to evaluate bone marrow edema (BMO) of sacroiliac joints (SIJs) by magnetic resonance imaging (MRI) in patients with axial spondyloarthritis (axSpA) and to compare with the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system. METHODS From September 2013 to March 2022, patients with axSpA who underwent 3.0T SIJ-MRI were included and were randomly divided into training and validation cohorts at a ratio of 7:3. The optimal radiomics features selected from the SIJ-MRI in the training cohort were included to generate the radiomics model. The performance of the model was evaluated by ROC analysis and decision curve analysis (DCA). Rad scores were calculated using the radiomics model. The responsiveness was compared for Rad scores and SPARCC scores. We also assessed the correlation between the Rad score and SPARCC score. RESULTS A total of 558 patients were finally included. The radiomics model showed favorable discrimination of a SPARCC score <2 or ≥2 both in the training (AUC, 0.90; 95% CI: 0.87-0.93) and validation cohorts (AUC, 0.90; 95% CI, 0.86-0.95). DCA confirmed that the model was clinically useful. Rad score showed higher responsiveness to treatment-related change than SPARCC score. Furthermore, a significant correlation was noted between the Rad score and SPARCC score when scoring the status of BMO (rs=0.80, P < 0.001), and a strong correlation was noted when scoring the change in BMO (r=0.70, P < 0.001). CONCLUSION The study proposed a radiomics model to accurately quantify the BMO of SIJs in patients with axSpA, providing an alternative to the SPARCC scoring system. Key Points • The Rad score is an index with high validity for the objective and quantitative evaluation of bone marrow edema (BMO) of the sacroiliac joints in axial spondyloarthritis. • The Rad score is a promising tool to monitor the change of BMO upon treatment.
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Tabari A, Chan SM, Omar OMF, Iqbal SI, Gee MS, Daye D. Role of Machine Learning in Precision Oncology: Applications in Gastrointestinal Cancers. Cancers (Basel) 2022; 15:cancers15010063. [PMID: 36612061 PMCID: PMC9817513 DOI: 10.3390/cancers15010063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Gastrointestinal (GI) cancers, consisting of a wide spectrum of pathologies, have become a prominent health issue globally. Despite medical imaging playing a crucial role in the clinical workflow of cancers, standard evaluation of different imaging modalities may provide limited information. Accurate tumor detection, characterization, and monitoring remain a challenge. Progress in quantitative imaging analysis techniques resulted in "radiomics", a promising methodical tool that helps to personalize diagnosis and treatment optimization. Radiomics, a sub-field of computer vision analysis, is a bourgeoning area of interest, especially in this era of precision medicine. In the field of oncology, radiomics has been described as a tool to aid in the diagnosis, classification, and categorization of malignancies and to predict outcomes using various endpoints. In addition, machine learning is a technique for analyzing and predicting by learning from sample data, finding patterns in it, and applying it to new data. Machine learning has been increasingly applied in this field, where it is being studied in image diagnosis. This review assesses the current landscape of radiomics and methodological processes in GI cancers (including gastric, colorectal, liver, pancreatic, neuroendocrine, GI stromal, and rectal cancers). We explain in a stepwise fashion the process from data acquisition and curation to segmentation and feature extraction. Furthermore, the applications of radiomics for diagnosis, staging, assessment of tumor prognosis and treatment response according to different GI cancer types are explored. Finally, we discussed the existing challenges and limitations of radiomics in abdominal cancers and investigate future opportunities.
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Affiliation(s)
- Azadeh Tabari
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- Correspondence:
| | - Shin Mei Chan
- Yale University School of Medicine, 330 Cedar Street, New Haven, CT 06510, USA
| | - Omar Mustafa Fathy Omar
- Center for Vascular Biology, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Shams I. Iqbal
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Michael S. Gee
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Dania Daye
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
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Computed tomography-based radiomics nomogram for the preoperative prediction of perineural invasion in colorectal cancer: a multicentre study. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:3251-3263. [PMID: 35960308 DOI: 10.1007/s00261-022-03620-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To develop and validate a computed tomography (CT) radiomics nomogram from multicentre datasets for preoperative prediction of perineural invasion (PNI) in colorectal cancer. METHODS A total of 299 patients with histologically confirmed colorectal cancer from three hospitals were enrolled in this retrospective study. Radiomic features were extracted from the whole tumour volume. The least absolute shrinkage and selection operator logistic regression was applied for feature selection and radiomics signature construction. Finally, a radiomics nomogram combining the radiomics score and clinical predictors was established. The receiver operating characteristic curve and decision curve analysis (DCA) were used to evaluate the predictive performance of the radiomics nomogram in the training cohort, internal validation and external validation cohorts. RESULTS Twelve radiomics features extracted from the whole tumour volume were used to construct the radiomics model. The area under the curve (AUC) values of the radiomics model in the training cohort, internal validation cohort, external validation cohort 1, and external validation cohort 2 were 0.82 (0.75-0.90), 0.77 (0.62-0.92), 0.71 (0.56-0.85), and 0.73 (0.60-0.85), respectively. The nomogram, which combined the radiomics score with T category and N category by CT, yielded better performance in the training cohort (AUC = 0.88), internal validation cohort (AUC = 0.80), external validation cohort 1 (AUC = 0.75), and external validation cohort 2 (AUC = 0.76). DCA confirmed the clinical utility of the nomogram. CONCLUSIONS The CT-based radiomics nomogram has the potential to accurately predict PNI in patients with colorectal cancer.
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Zhan PC, Lyu PJ, Li Z, Liu X, Wang HX, Liu NN, Zhang Y, Huang W, Chen Y, Gao JB. CT-Based Radiomics Analysis for Noninvasive Prediction of Perineural Invasion of Perihilar Cholangiocarcinoma. Front Oncol 2022; 12:900478. [PMID: 35795043 PMCID: PMC9252420 DOI: 10.3389/fonc.2022.900478] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/20/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose The study aimed to construct and evaluate a CT-Based radiomics model for noninvasive detecting perineural invasion (PNI) of perihilar cholangiocarcinoma (pCCA) preoperatively. Materials and Methods From February 2012 to October 2021, a total of 161 patients with pCCA who underwent resection were retrospectively enrolled in this study. Patients were allocated into the training cohort and the validation cohort according to the diagnostic time. Venous phase images of contrast-enhanced CT were used for radiomics analysis. The intraclass correlation efficient (ICC), the correlation analysis, and the least absolute shrinkage and selection operator (LASSO) regression were applied to select radiomics features and built radiomics signature. Logistic regression analyses were performed to establish a clinical model, a radiomics model, and a combined model. The performance of the predictive models was measured by area under the receiver operating characteristic curve (AUC), and pairwise ROC comparisons between models were tested using the Delong method. Finally, the model with the best performance was presented as a nomogram, and its calibration and clinical usefulness were assessed. Results Finally, 15 radiomics features were selected to build a radiomics signature, and three models were developed through logistic regression. In the training cohort, the combined model showed a higher predictive capability (AUC = 0.950) than the radiomics model and the clinical model (AUC: radiomics = 0.914, clinical = 0.756). However, in the validation cohort, the AUC of the radiomics model (AUC = 0.885) was significantly higher than the other two models (AUC: combined = 0.791, clinical = 0.567). After comprehensive consideration, the radiomics model was chosen to develop the nomogram. The calibration curve and decision curve analysis (DCA) suggested that the nomogram had a good consistency and clinical utility. Conclusion We developed a CT-based radiomics model with good performance to noninvasively predict PNI of pCCA preoperatively.
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Affiliation(s)
- Peng-Chao Zhan
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Imaging Diagnosis and Treatment for Digestive System Tumor, Zhengzhou, China
| | - Pei-jie Lyu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhen Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xing Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui-Xia Wang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Na-Na Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Imaging Diagnosis and Treatment for Digestive System Tumor, Zhengzhou, China
| | - Yuyuan Zhang
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenpeng Huang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Imaging Diagnosis and Treatment for Digestive System Tumor, Zhengzhou, China
| | - Yan Chen
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian-bo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Imaging Diagnosis and Treatment for Digestive System Tumor, Zhengzhou, China
- *Correspondence: Jian-bo Gao, ; Pei-jie Lyu,
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