基于超声造影的超声组学评分：一种预测肝癌切除或消融术后早期复发的潜在生物标志物。
Contrast-enhanced ultrasound-based ultrasomics score: a potential biomarker for predicting early recurrence of hepatocellular carcinoma after resection or ablation.
机构信息
Department of Medical Ultrasonics, Ultrasomics Artificial Intelligence X-Lab, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital, Sun Yat-SenUniversity, Guangzhou, China.
出版信息
Br J Radiol. 2022 Feb 1;95(1130):20210748. doi: 10.1259/bjr.20210748. Epub 2021 Nov 29.
OBJECTIVES
This study aimed to construct a prediction model based on contrast-enhanced ultrasound (CEUS) ultrasomics features and investigate its efficacy in predicting early recurrence (ER) of primary hepatocellular carcinoma (HCC) after resection or ablation.
METHODS
This study retrospectively included 215 patients with primary HCC, who were divided into a developmental cohort ( = 139) and a test cohort ( = 76). Four representative images-grayscale ultrasound, arterial phase, portal venous phase and delayed phase-were extracted from each CEUS video. Ultrasomics features were extracted from tumoral and peritumoral area inside the region of interest. Logistic regression was used to establish models, including a tumoral model, a peritumoral model and a combined model with additional clinical risk factors. The performance of the three models in predicting recurrence within 2 years was verified.
RESULTS
The combined model performed best in predicting recurrence within 2 years, with an area under the curve (AUC) of 0.845, while the tumoral model had an AUC of 0.810 and the peritumoral model one of 0.808. For prediction of recurrence-free survival, the 2-year cumulative recurrence rate was significant higher in the high-risk group (76.5%) than in the low-risk group (9.5%; < 0.0001).
CONCLUSION
These CEUS ultrasomics models, especially the combined model, had good efficacy in predicting early recurrence of HCC. The combined model has potential for individual survival assessment for HCC patients undergoing resection or ablation.
ADVANCES IN KNOWLEDGE
CEUS ultrasomics had high sensitivity, specificity and PPV in diagnosing early recurrence of HCC, and high efficacy in predicting early recurrence of HCC (AUC > 0.8). The combined model performed better than the tumoral ultrasomics model and peritumoral ultrasomics model in predicting recurrence within 2 years. Recurrence was more likely to occur in the high-risk group than in the low-risk group, with 2-year cumulative recurrence rates, respectively, 76.5% and 9.5% ( < 0.0001).
目的
本研究旨在构建基于超声造影（CEUS）超声特征的预测模型，并探讨其预测原发性肝细胞癌（HCC）切除或消融后早期复发（ER）的效能。
方法
本研究回顾性纳入 215 例原发性 HCC 患者，分为发展队列（n = 139）和测试队列（n = 76）。从每个 CEUS 视频中提取 4 个代表性图像-灰阶超声、动脉期、门静脉期和延迟期。从感兴趣区域内的肿瘤和肿瘤周围区域提取超声特征。使用逻辑回归建立模型，包括肿瘤模型、肿瘤周围模型和添加临床危险因素的联合模型。验证了这三个模型在预测 2 年内复发的性能。
结果
联合模型在预测 2 年内复发方面表现最佳，曲线下面积（AUC）为 0.845，而肿瘤模型的 AUC 为 0.810，肿瘤周围模型的 AUC 为 0.808。对于无复发生存预测，高危组（76.5%）的 2 年累积复发率显著高于低危组（9.5%；<0.0001）。
结论
这些 CEUS 超声特征模型，特别是联合模型，在预测 HCC 的早期复发方面具有良好的效果。联合模型有可能对接受切除或消融治疗的 HCC 患者进行个体生存评估。
知识进展
CEUS 超声特征在诊断 HCC 早期复发方面具有较高的灵敏度、特异性和阳性预测值，在预测 HCC 早期复发方面具有较高的效能（AUC>0.8）。联合模型在预测 2 年内复发方面优于肿瘤超声特征模型和肿瘤周围超声特征模型。高危组的复发风险高于低危组，2 年累积复发率分别为 76.5%和 9.5%（<0.0001）。
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