Radiomics-Based Preoperative Prediction of Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma Using Contrast-Enhanced Computed Tomography
Radiomics-Based Preoperative Prediction of Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma Using Contrast-Enhanced Computed Tomography
复制标题
使用对比增强计算机断层扫描基于放射组学的肝内胆管癌淋巴结转移的术前预测
DOI：
10.1245/s10434-022-12028-8
复制
发表时间：
2022-07
影响因子：
3.7
通讯作者：
Jun Li
中科院分区：
文献类型：
--
作者：
Shuaitong Zhang;Shengyu Huang;Wei He;Jingwei Wei;Lei Huo;Ningyang Jia;Jianbo Lin;Zhenchao Tang;Yunfei Yuan;Jie Tian;Feng Shen;Jun Li
在肝内胆管细胞癌(ICC)患者中，淋巴结(LN)转移与预后不良密切相关。改善对LN转移的术前评估有助于治疗决策。目的探讨放射组学方法在预测颈动脉内癌患者LN转移中的作用。方法对在中国两中心行根治性肝切除和淋巴结清扫的2 96例肝内胆管癌患者进行分析。从四相CT图像中提取放射状特征，包括基于直方图和小波的特征、形状和大小特征以及纹理特征。临床和传统的放射学变量与淋巴结转移的独立相关也被识别。建立了一个预测LN转移的组合诺模图，其性能取决于对长期预后的区分、校准和分层。结果筛选出24个放射学特征进入诺模图。建立的诺模图具有良好的区分性和校准性，在训练和两个验证队列中，曲线下面积(AUC)分别为0.98[95%可信区间(CI)0.93(0.88-0.98)和0.89(0.81-0.96)]。训练队列中LN转移高危患者的5年总生存率和无复发生存率低于低危患者(OS 28.8%vs53.9%，p<；0.001；rFS 26.3%vs44.2%，p=0.001)。结论放射组学方法为ICC患者提供了准确的LN转移预测和预后评估，有助于手术前的决策。
BackgroundLymph node (LN) metastasis is significantly associated with worse prognosis for patients with intrahepatic cholangiocarcinoma (ICC). Improvement in preoperative assessment on LN metastasis helps in treatment decision-making. We aimed to investigate the role of radiomics-based method in predicting LN metastasis for patients with ICC.MethodsA total of 296 patients with ICC who underwent curative-intent hepatectomy and lymphadenectomy at two centers in China were analyzed. Radiomic features, including histogram- and wavelet-based features, shape and size features, and texture features were extracted from four-phase computerized tomography (CT) images. The clinical and conventional radiological variables which were independently associated with LN metastasis were also identified. A combined nomogram predicting LN metastasis was developed, and its performance was determined by discrimination, calibration, and stratification of long-term prognosis. The results were validated by the internal and external validation cohorts.ResultsTwenty-four radiomic features were selected into the nomogram. The established nomogram demonstrated good discrimination and calibration, with areas under the curve (AUCs) of 0.98 [95% confidence interval (CI) 0.93 (0.88–0.98), and 0.89 (0.81–0.96) in the training and two validation cohorts, respectively. The 5-year overall survival (OS) and recurrence-free survival (RFS) rates of patients with high risk of LN metastasis as grouped by nomogram were poorer than those of patients with low risk in the training cohort (OS 28.8% versus 53.9%, p < 0.001; RFS 26.3% versus 44.2%, p = 0.001). Similar results were observed in the two validation cohorts.ConclusionsRadiomics-based method provided accurate prediction of LN metastasis and prognostic assessment for ICC patients, and might aid the preoperative surgical decision.
登录
查看更多内容
影响因子：
3.5
作者：
Polan DF;Brady SL;Kaufman RA
通讯作者：
Kaufman RA
影响因子：
2.2
作者：
Meng, Ze-Wu;Lin, Xiu-Quan;Chen, Yan-Ling
通讯作者：
Chen, Yan-Ling
DOI：
10.2174/9781681082851116010019
发表时间：
2014-10
期刊：
Radiopaedia.org
影响因子：
--
作者：
Jan Gerstenmaier
通讯作者：
Jan Gerstenmaier
影响因子：
19.7
作者：
Thoeny, Harriet C.;Froehlich, Johannes M.;Studer, Urs E.
通讯作者：
Studer, Urs E.
DOI：
10.4166/kjg.2017.69.3.159
发表时间：
2017-03-25
影响因子：
--
作者：
Kim, So Yeon
通讯作者：
Kim, So Yeon