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[磁共振成像的影像组学列线图:预测喉癌颈部淋巴结转移]

[Radiomics nomogram of MR: a prediction of cervical lymph node metastasis in laryngeal cancer].

作者信息

Jia C L, Cao Y, Song Q, Zhang W B, Li J J, Wu X X, Yu P Y, Mou Y K, Mao N, Song X C

机构信息

Big Data and Artificial Intelligence Laboratory, Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China.

Department of Otorhinolaryngology Head and Neck Surgery, Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Dec 7;55(12):1154-1161. doi: 10.3760/cma.j.cn115330-20200719-00604.

Abstract

To establish and validate a radiomics nomogram based on MR for predicting cervical lymph node metastasis in laryngeal cancer. One hundred and seventeen patients with laryngeal cancer who underwent MR examinations and received open surgery and neck dissection between January 2016 and December 2019 were included in this study. All patients were randomly divided into a training cohort (=89) and test cohort (=28) using computer-generated random numbers. Clinical characteristics and MR were collected. Radiological features were extracted from the MR images. Enhanced T1 and T2WI were selected for radiomics analysis, and the volume of interest was manually segmented from the Huiyihuiying radiomics cloud platform. The variance analysis (ANOVA) and the least absolute shrinkage and selection operator (LASSO) algorithm were used to reduce the dimensionality of the radiomics features in the training cohort. Then, a radiomic signature was established. The clinical risk factors were screened by using ANOVA and multivariate logistic regression. A nomogram was generated using clinical risk factors and the radiomic signature. The calibration curve and receiver operator characteristic (ROC) curve were used to confirm the nomogram's performance in the training and test sets. The clinical usefulness of the nomogram was evaluated by decision curve analysis (DCA). Furthermore, a testing cohort was used to validate the model. The radiomics signature consisted of 21 features, and the nomogram model included the radiomics signature and the MR-reported lymph node status. The model showed good calibration and discrimination. The model yielded areas under the ROC curve (AUC) in the training cohort, specificity, and sensitivity of 0.930, 0.930 and 0.875. In the test cohort, the model yielded AUC, specificity and sensitivity of 0.883, 0.889 and 0.800. DCA indicated that the nomogram model was clinically useful. The MR-based radiomics nomogram model may be used to predict cervical lymph node metastasis of laryngeal cancer preoperatively. MR-based radiomics could serve as a potential tool to help clinicians make an optimal clinical decision.

摘要

建立并验证基于磁共振成像(MR)的放射组学列线图,以预测喉癌颈淋巴结转移。本研究纳入了2016年1月至2019年12月期间接受MR检查并接受开放手术及颈部清扫术的117例喉癌患者。使用计算机生成的随机数将所有患者随机分为训练队列(n = 89)和测试队列(n = 28)。收集临床特征和MR数据。从MR图像中提取放射学特征。选择增强T1加权像和T2加权像进行放射组学分析,并在慧医慧影放射组学云平台上手动分割感兴趣体积。在训练队列中,使用方差分析(ANOVA)和最小绝对收缩和选择算子(LASSO)算法对放射组学特征进行降维。然后,建立放射组学特征。通过ANOVA和多因素逻辑回归筛选临床危险因素。使用临床危险因素和放射组学特征生成列线图。校准曲线和受试者工作特征(ROC)曲线用于确认列线图在训练集和测试集的性能。通过决策曲线分析(DCA)评估列线图的临床实用性。此外,使用一个测试队列对模型进行验证。放射组学特征由21个特征组成,列线图模型包括放射组学特征和MR报告的淋巴结状态。该模型显示出良好的校准和区分能力。在训练队列中,该模型的ROC曲线下面积(AUC)、特异性和敏感性分别为0.930、0.930和0.875。在测试队列中,该模型的AUC、特异性和敏感性分别为0.883、0.889和0.800。DCA表明列线图模型具有临床实用性。基于MR的放射组学列线图模型可用于术前预测喉癌颈淋巴结转移。基于MR的放射组学可作为一种潜在工具,帮助临床医生做出最佳临床决策。

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