Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
GE Healthcare, Shanghai, China.
Korean J Radiol. 2022 Jan;23(1):89-100. doi: 10.3348/kjr.2021.0323.
To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI).
A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test.
The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD.
We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.
通过放射组学提高淀粉样蛋白/tau/神经退行性变系统中的 N 标志物，并研究其在预测轻度认知障碍（MCI）个体认知进展中的价值。
纳入了一组 147 名健康对照者（HCs）（72 名男性；平均年龄±标准差，73.7±6.3 岁）、197 名 MCI 患者（114 名男性；72.2±7.1 岁）和 128 名阿尔茨海默病（AD）患者（74 名男性；73.7±8.4 岁）。使用受试者工作特征（ROC）曲线分析选择最佳的 A、T 和 N 生物标志物以区分 HCs 和 AD。建立了一个包含整个大脑皮层和深部核团综合信息的放射组学模型，以创建新的 N 生物标志物。评估脑脊液（CSF）生物标志物以确定最佳的 A 或 T 生物标志物。所有 MCI 患者均进行随访，直至 AD 转化或至少随访 60 个月。使用 Kaplan-Meier 估计和对数秩检验分析 A、T 和基于放射组学的 N 生物标志物对 MCI 向 AD 认知进展的预测价值。
基于放射组学的 N 生物标志物在区分 AD 和 HCs 方面的 ROC 曲线面积为 0.998。CSF Aβ42 和 p-tau 蛋白分别被确定为最佳的 A 和 T 生物标志物。对于处于阿尔茨海默病连续体上的 MCI 患者，孤立的 A+是认知稳定的指标，而 T 和 N 的异常，单独或同时出现，则表明进展风险较高。对于疑似非阿尔茨海默病病理生理学的 MCI 患者，孤立的 T+表示认知稳定，而基于放射组学的 N+的出现则表示向 AD 进展的高风险。
我们提出了一种新的基于放射组学的改良 N 生物标志物，有助于识别认知进展风险较高的 MCI 患者。此外，我们阐明了单个 A/T/N 生物标志物预测 MCI 认知进展的价值。
