Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, 313000, China.
GE Healthcare, Hangzhou, 310000, China.
Sci Rep. 2021 Jun 8;11(1):12009. doi: 10.1038/s41598-021-91508-5.
To explore the application of computed tomography (CT)-enhanced radiomics for the risk-grade prediction of gastrointestinal stromal tumors (GIST). GIST patients (n = 292) confirmed by surgery or endoscopic pathology during June 2013-2019 were reviewed and categorized into low-grade (very low to low risk) and high-grade (medium to high risk) groups. The tumor region of interest (ROI) was depicted layer by layer on each patient's enhanced CT venous phase images using the ITK-SNAP. The texture features were extracted using the Analysis Kit (AK) and then randomly divided into the training (n = 205) and test (n = 87) groups in a ratio of 7:3. After dimension reduction by the least absolute shrinkage and the selection operator algorithm (LASSO), a prediction model was constructed using the logistic regression method. The clinical data of the two groups were statistically analyzed, and the multivariate regression prediction model was constructed by using statistically significant features. The ROC curve was applied to evaluate the prediction performance of the proposed model. A radiomics-prediction model was constructed based on 10 characteristic parameters selected from 396 quantitative feature parameters extracted from the CT images. The proposed radiomics model exhibited effective risk-grade prediction of GIST. For the training group, the area under curve (AUC), sensitivity, specificity, and accuracy rate were 0.793 (95%CI: 0.733-0.854), 83.3%, 64.3%, and 72.7%, respectively; the corresponding values for the test group were 0.791 (95%CI: 0.696-0.886), 84.2%, 69.3%, and 75.9%, respectively. There were significant differences in age (t value: - 3.133, P = 0.008), maximum tumor diameter (Z value: - 12.163, P = 0.000) and tumor morphology (χ value:10.409, P = 0.001) between the two groups, which were used to establish a clinical prediction model. The area under the receiver operating characteristic curve of the clinical model was 0.718 (95%CI: 0.659-0.776). The proposed CT-enhanced radiomics model exhibited better accuracy and effective performance than the clinical model, which can be used for the assessment of risk grades of GIST.
探讨 CT 增强放射组学在胃肠道间质瘤(GIST)风险分级预测中的应用。回顾分析 2013 年 6 月至 2019 年期间经手术或内镜病理证实的 GIST 患者(n=292),并分为低级别(极低至低危)和高级别(中高危)组。采用 ITK-SNAP 在每位患者的增强 CT 静脉期图像上逐层描绘肿瘤感兴趣区(ROI)。使用 Analysis Kit(AK)提取纹理特征,然后按 7:3 的比例随机分为训练组(n=205)和测试组(n=87)。通过最小绝对收缩和选择算子算法(LASSO)降维后,使用逻辑回归方法构建预测模型。对两组的临床资料进行统计学分析,采用有统计学意义的特征构建多变量回归预测模型。应用 ROC 曲线评估所提出模型的预测性能。基于从 CT 图像中提取的 396 个定量特征参数中选择的 10 个特征参数,构建了一个放射组学预测模型。该放射组学模型可有效预测 GIST 的风险分级。对于训练组,曲线下面积(AUC)、灵敏度、特异度和准确率分别为 0.793(95%CI:0.733-0.854)、83.3%、64.3%和 72.7%;对于测试组,AUC、灵敏度、特异度和准确率分别为 0.791(95%CI:0.696-0.886)、84.2%、69.3%和 75.9%。两组间年龄(t 值:-3.133,P=0.008)、最大肿瘤直径(Z 值:-12.163,P=0.000)和肿瘤形态(χ 值:10.409,P=0.001)差异有统计学意义,用于建立临床预测模型。临床模型的受试者工作特征曲线下面积为 0.718(95%CI:0.659-0.776)。与临床模型相比,提出的 CT 增强放射组学模型具有更好的准确性和有效性,可用于评估 GIST 的风险分级。