Gadoxetic acid-enhanced MRI radiomics signature: prediction of clinical outcome in hepatocellular carcinoma after surgical resection.
Gadoxetic acid-enhanced MRI radiomics signature: prediction of clinical outcome in hepatocellular carcinoma after surgical resection.
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DOI：
10.21037/atm-20-3041
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发表时间：
2020-06
影响因子：
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通讯作者：
Zhen Zhang;Jie Chen;Hanyu Jiang;Yi Wei;Xin Zhang;Likun Cao;Ting Duan;Z. Ye;S. Yao;Xuelin Pan;B. Song
中科院分区：
文献类型：
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作者：
Zhen Zhang;Jie Chen;Hanyu Jiang;Yi Wei;Xin Zhang;Likun Cao;Ting Duan;Z. Ye;S. Yao;Xuelin Pan;B. Song
本研究旨在评价钆塞酸增强MRI放射组学特征预测肝细胞癌（HCC）患者手术切除后总生存期（OS）的有效性。方法本前瞻性研究纳入了120例经病理证实的HCC患者。利用最小绝对收缩和选择算子（LASSO）考克斯回归分析从3个不同感兴趣区域（ROI）中的放射组学特征构建放射组学特征（rad-score）。术前临床特征和语义成像特征可能与患者的生存进行了评估，以开发一个临床放射学模型。使用多变量考克斯回归分析将放射组学特征和临床-放射学预测因子整合到联合模型中。进行Kaplan-Meier分析和对数秩检验以比较区分性能，并对验证队列进行评价。结果放射组学特征与两组患者的生存率均显著相关（均P<0.001）。BCLC（巴塞罗那诊所肝癌）分期、非光滑肿瘤边缘和联合rad评分与OS独立相关。此外，结合临床放射学和放射组学特征的联合模型显示出改善的预测性能，C指数为0.92 [95%置信区间（CI）：0.87-0.97]，与临床放射学模型（C指数，0.86，95% CI：0.79-0.94; P=0.039）或联合放射学评分（C指数，0.88，95% CI：0.81-0.95; P=0.016）相比。结论放射组学特征沿着临床-影像学预测指标，可有效辅助肝癌手术切除后的术前预后预测，使精确医学向前迈进一步。
Background This study aimed to evaluate the efficiency of gadoxetic acid-enhanced MRI-based radiomics features for prediction of overall survival (OS) in hepatocellular carcinoma (HCC) patients after surgical resection. Methods This prospective study approved by the Institutional Review Board enrolled 120 patients with pathologically confirmed HCC. Radiomics signatures (rad-scores) were built from radiomics features in 3 different regions of interest (ROIs) with the least absolute shrinkage and selection operator (LASSO) cox regression analysis. Preoperative clinical characteristics and semantic imaging features potentially associated with patient survival were evaluated to develop a clinic-radiological model. The radiomics features and clinic-radiological predictors were integrated into a joint model using multivariable Cox regression analysis. Kaplan-Meier analysis and log-rank tests were performed to compare the discriminative performance and evaluated on the validation cohort. Results The radiomics signatures showed a significant association with patient survival in both cohorts (all P<0.001). The BCLC (Barcelona clinic liver cancer) stage, non-smooth tumor margin, and the combined rad-score were independently associated with OS. Moreover, the combined model incorporating with clinic-radiological and radiomics features showed an improved predictive performance with C-index of 0.92 [95% confidence interval (CI): 0.87-0.97], compared to the clinic-radiological model (C-index, 0.86, 95% CI: 0.79-0.94; P=0.039) or the combined rad-score (C-index, 0.88, 95% CI: 0.81-0.95; P=0.016). Conclusions Radiomics features along with clinic-radiological predictors can efficiently aid in preoperative HCC prognosis prediction after surgical resection and enable a step forward precise medicine.