Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Department of Radiology, Stanford University, Stanford, CA.
JCO Clin Cancer Inform. 2021 Jun;5:746-757. doi: 10.1200/CCI.21.00021.
Small-cell lung cancer (SCLC) is the deadliest form of lung cancer, partly because of its short doubling time. Delays in imaging identification and diagnosis of nodules create a risk for stage migration. The purpose of our study was to determine if a machine learning radiomics model can detect SCLC on computed tomography (CT) among all nodules at least 1 cm in size.
Computed tomography scans from a single institution were selected and resampled to 1 × 1 × 1 mm. Studies were divided into SCLC and other scans comprising benign, adenocarcinoma, and squamous cell carcinoma that were segregated into group A (noncontrast scans) and group B (contrast-enhanced scans). Four machine learning classification models, support vector classifier, random forest (RF), XGBoost, and logistic regression, were used to generate radiomic models using 59 quantitative first-order and texture Imaging Biomarker Standardization Initiative compliant PyRadiomics features, which were found to be robust between two segmenters with minimum Redundancy Maximum Relevance feature selection within each leave-one-out-cross-validation to avoid overfitting. The performance was evaluated using a receiver operating characteristic curve. A final model was created using the RF classifier and aggregate minimum Redundancy Maximum Relevance to determine feature importance.
A total of 103 studies were included in the analysis. The area under the receiver operating characteristic curve for RF, support vector classifier, XGBoost, and logistic regression was 0.81, 0.77, 0.84, and 0.84 in group A, and 0.88, 0.87, 0.85, and 0.81 in group B, respectively. Nine radiomic features in group A and 14 radiomic features in group B were predictive of SCLC. Six radiomic features overlapped between groups A and B.
A machine learning radiomics model may help differentiate SCLC from other lung lesions.
小细胞肺癌(SCLC)是肺癌中最致命的一种,部分原因是其倍增时间短。影像学对结节的识别和诊断的延迟增加了分期转移的风险。本研究的目的是确定机器学习放射组学模型是否可以在至少 1 厘米大小的所有结节中检测到 CT 上的 SCLC。
选择了来自单个机构的 CT 扫描并重新采样为 1×1×1mm。研究分为 SCLC 和其他扫描,包括良性、腺癌和鳞状细胞癌,分为组 A(非对比扫描)和组 B(对比增强扫描)。使用支持向量分类器、随机森林(RF)、XGBoost 和逻辑回归四种机器学习分类模型,使用 59 种定量一阶和纹理成像生物标志物标准化倡议兼容的 PyRadiomics 特征生成放射组学模型,在两位分割者之间发现这些特征具有稳健性,并且在每次留一交叉验证中都使用最小冗余最大相关性特征选择,以避免过度拟合。使用接收者操作特征曲线评估性能。使用 RF 分类器和聚合最小冗余最大相关性创建最终模型,以确定特征的重要性。
共纳入 103 项研究进行分析。在组 A 中,RF、支持向量分类器、XGBoost 和逻辑回归的接收者操作特征曲线下面积分别为 0.81、0.77、0.84 和 0.84,在组 B 中分别为 0.88、0.87、0.85 和 0.81。在组 A 中有 9 个放射组学特征,在组 B 中有 14 个放射组学特征可以预测 SCLC。在组 A 和 B 之间有 6 个放射组学特征重叠。
机器学习放射组学模型可能有助于区分 SCLC 和其他肺部病变。