Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China; Department of Radiology, Nanchong Central Hospital/Second School of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan, China.
Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China.
Clin Radiol. 2019 Dec;74(12):976.e1-976.e9. doi: 10.1016/j.crad.2019.08.028. Epub 2019 Oct 8.
To develop liver a computed tomography (CT) radiomics model to predict gastro-oesophageal variceal bleeding (GVB) secondary to hepatitis B-related cirrhosis.
Electronic medical records and image data of liver triple-phase contrast-enhanced CT examinations of 295 patients with hepatitis B-related cirrhosis were collected retrospectively from two hospitals. Two hundred and thirty-six and 59 patients were enrolled randomly into the training and validation cohorts, respectively; and 75 in the training cohort and 16 in the validation cohort endured GVB while the others did not during follow-up period. Radiomics features of the liver were extracted from the portal venous phase images, and clinical features came from medical records. The tree-based method and univariate feature selection were used to select useful features. The radiomics model, clinical model, and integration of radiomics and clinical models were built using the useful image features and/or clinical features. Predicting performance of three models was evaluated with the area under receiver-operating characteristic curve (AUC), accuracy, and F-1 score.
Twenty-one useful radiomics features and/or three clinical features were selected to build prediction models that correlated with GVB. AUC of integration of radiomics and clinical models was larger than of clinical or radiomics models for the training cohort (0.83±0.09 versus 0.64±0.08 or 0.82±0.10) and the validation cohort (0.64 versus 0.61 or 0.61). Integration of radiomics and clinical models obtained good performance in predicting GVB for both the training and validation cohorts (accuracy: 0.76±0.07 and 0.73, and F-1 score: 0.77±0.09 and 0.72, respectively).
Integration of the radiomics and clinical models may be a non-invasive method to predict GVB.
建立一种基于肝脏 CT 放射组学模型来预测乙型肝炎相关肝硬化患者胃食管静脉曲张出血(GVB)。
本研究回顾性收集了两家医院 295 例乙型肝炎相关肝硬化患者的肝脏三期增强 CT 影像资料和电子病历。其中 236 例患者被随机纳入训练队列,59 例患者被纳入验证队列;在随访期间,75 例患者发生 GVB,其余患者未发生 GVB。从门静脉期图像中提取肝脏放射组学特征,并从病历中提取临床特征。采用基于树的方法和单变量特征选择来筛选有用特征。使用有用的图像特征和/或临床特征构建放射组学模型、临床模型和放射组学与临床模型集成模型。采用受试者工作特征曲线(ROC)下面积(AUC)、准确率和 F-1 评分评估三种模型的预测性能。
筛选出 21 个有用的放射组学特征和/或 3 个临床特征来构建与 GVB 相关的预测模型。对于训练队列,放射组学与临床模型的 AUC 大于临床模型或放射组学模型(0.83±0.09 比 0.64±0.08 或 0.82±0.10),对于验证队列,放射组学与临床模型的 AUC 大于临床模型(0.64 比 0.61 或 0.61)。放射组学与临床模型在训练队列和验证队列中均具有良好的 GVB 预测性能(准确率:0.76±0.07 和 0.73,F-1 评分:0.77±0.09 和 0.72)。
放射组学与临床模型的结合可能是一种预测 GVB 的非侵入性方法。