Department of Radiology, Changhai Hospital, Naval Medical University, Changhai Road 168, Shanghai, 200434, China.
Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai, China.
Abdom Radiol (NY). 2022 Jan;47(1):242-253. doi: 10.1007/s00261-021-03285-4. Epub 2021 Oct 28.
To develop and validate a machine-learning classifier based on contrast-enhanced computed tomography (CT) for the preoperative prediction of CD20 B lymphocyte expression in patients with pancreatic ductal adenocarcinoma (PDAC).
Overall, 189 patients with PDAC (n = 132 and n = 57 in the training and validation sets, respectively) underwent immunohistochemistry and radiomics feature extraction. The X-tile software was used to stratify them into groups with 'high' and 'low' CD20 B lymphocyte expression levels. For each patient, 1409 radiomic features were extracted from volumes of interest and reduced using variance analysis and Spearman correlation analysis. A multilayer perceptron (MLP) network classifier was developed using the training and validation set. Model performance was determined by its discriminative ability, calibration, and clinical utility.
A log-rank test showed that the patients with high CD20 B expression had significantly longer survival than those with low CD20 B expression. The prediction model showed good discrimination in both the training and validation sets. For the training set, the area under the curve (AUC), sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 0.82 (95% CI 0.74-0.89), 92.42%, 57.58%, 0.75, 0.69, and 0.88, respectively; whereas these values for the validation set were 0.84 (95% CI 0.72-0.93), 86.21%, 78.57%, 0.83, 0.81, and 0.85, respectively.
The MLP network classifier based on contrast-enhanced CT can accurately predict CD20 B expression in patients with PDAC.
开发并验证一种基于增强 CT 的机器学习分类器,用于术前预测胰腺导管腺癌(PDAC)患者的 CD20 B 淋巴细胞表达。
共 189 例 PDAC 患者(训练集 132 例,验证集 57 例)行免疫组化和放射组学特征提取。采用 X-tile 软件将其分为 CD20 B 淋巴细胞高表达组和低表达组。对每位患者,从感兴趣区域提取 1409 个放射组学特征,通过方差分析和 Spearman 相关分析进行降维。采用训练集和验证集开发多层感知机(MLP)网络分类器。通过判别能力、校准和临床实用性来评估模型性能。
对数秩检验显示,CD20 B 高表达患者的生存时间明显长于 CD20 B 低表达患者。预测模型在训练集和验证集均具有良好的判别能力。对于训练集,曲线下面积(AUC)、敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 0.82(95%CI 0.74-0.89)、92.42%、57.58%、0.75、0.69 和 0.88;验证集分别为 0.84(95%CI 0.72-0.93)、86.21%、78.57%、0.83、0.81 和 0.85。
基于增强 CT 的 MLP 网络分类器可准确预测 PDAC 患者的 CD20 B 表达。