基于增强外泌体磁共振成像的放射组学分析评估结直肠癌肝转移肝切除术后的临床结局

EOB-MR Based Radiomics Analysis to Assess Clinical Outcomes following Liver Resection in Colorectal Liver Metastases.

作者信息

Granata Vincenza, Fusco Roberta, De Muzio Federica, Cutolo Carmen, Setola Sergio Venanzio, Dell'Aversana Federica, Ottaiano Alessandro, Nasti Guglielmo, Grassi Roberta, Pilone Vincenzo, Miele Vittorio, Brunese Maria Chiara, Tatangelo Fabiana, Izzo Francesco, Petrillo Antonella

机构信息

Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli, 80131 Napoli, Italy.

Medical Oncology Division, Igea SpA, 41012 Carpi, Italy.

出版信息

Cancers (Basel). 2022 Feb 27;14(5):1239. doi: 10.3390/cancers14051239.

Abstract

The aim of this study was to assess the efficacy of radiomics features obtained by EOB-MRI phase in order to predict clinical outcomes following liver resection in Colorectal Liver Metastases Patients, and evaluate recurrence, mutational status, pathological characteristic (mucinous) and surgical resection margin. This retrospective analysis was approved by the local Ethical Committee board of National Cancer of Naples, IRCCS "Fondazione Pascale". Radiological databases were interrogated from January 2018 to May 2021 in order to select patients with liver metastases with pathological proof and EOB-MRI study in pre-surgical setting. The cohort of patients included a training set (51 patients with 61 years of median age and 121 liver metastases) and an external validation set (30 patients with single lesion with 60 years of median age). For each segmented volume of interest by 2 expert radiologists, 851 radiomics features were extracted as median values using PyRadiomics. non-parametric test, intraclass correlation, receiver operating characteristic (ROC) analysis, linear regression modelling and pattern recognition methods (support vector machine (SVM), k-nearest neighbors (KNN), artificial neural network (NNET), and decision tree (DT)) were considered. The best predictor to discriminate expansive versus infiltrative front of tumor growth was HLH_glcm_MaximumProbability extraxted on VIBE_FA30 with an accuracy of 84%, a sensitivity of 83%, and a specificity of 82%. The best predictor to discriminate tumor budding was Inverse Variance obtained by the original GLCM matrix extraxted on VIBE_FA30 with an accuracy of 89%, a sensitivity of 96% and a specificity of 65%. The best predictor to differentiate the mucinous type of tumor was the HHL_glszm_ZoneVariance extraxted on VIBE_FA30 with an accuracy of 85%, a sensitivity of 46% and a specificity of 95%. The best predictor to identify tumor recurrence was the LHL_glcm_Correlation extraxted on VIBE_FA30 with an accuracy of 86%, a sensitivity of 52% and a specificity of 97%. The best linear regression model was obtained in the identification of the tumor growth front considering the height textural significant metrics by VIBE_FA10 (an accuracy of 89%; sensitivity of 93% and a specificity of 82%). Considering significant texture metrics tested with pattern recognition approaches, the best performance for each outcome was reached by a KNN in the identification of recurrence with the 3 textural significant features extracted by VIBE_FA10 (AUC of 91%, an accuracy of 93%; sensitivity of 99% and a specificity of 77%). Ours results confirmed the capacity of radiomics to identify as biomarkers, several prognostic features that could affect the treatment choice in patients with liver metastases, in order to obtain a more personalized approach.

摘要

本研究旨在评估EOB-MRI各期获得的影像组学特征预测结直肠癌肝转移患者肝切除术后临床结局的效能,并评估复发情况、突变状态、病理特征(黏液性)和手术切缘。这项回顾性分析得到了那不勒斯国家癌症研究所IRCCS“帕斯卡尔基金会”当地伦理委员会的批准。查询了2018年1月至2021年5月的放射学数据库,以选择有病理证据且术前进行过EOB-MRI检查的肝转移患者。患者队列包括一个训练集(51例患者,中位年龄61岁,121个肝转移灶)和一个外部验证集(30例单发病变患者,中位年龄60岁)。对于2名专业放射科医生分割的每个感兴趣体积,使用PyRadiomics提取851个影像组学特征作为中位数。考虑了非参数检验、组内相关性、受试者操作特征(ROC)分析、线性回归建模和模式识别方法(支持向量机(SVM)、k近邻(KNN)、人工神经网络(NNET)和决策树(DT))。区分肿瘤生长的膨胀性与浸润性前沿的最佳预测指标是在VIBE_FA30上提取的HLH_glcm_MaximumProbability,准确率为84%,灵敏度为83%,特异度为82%。区分肿瘤芽生的最佳预测指标是在VIBE_FA30上提取的原始GLCM矩阵的Inverse Variance,准确率为89%,灵敏度为96%,特异度为65%。区分黏液性肿瘤类型的最佳预测指标是在VIBE_FA30上提取的HHL_glszm_ZoneVariance,准确率为85%,灵敏度为46%,特异度为95%。识别肿瘤复发的最佳预测指标是在VIBE_FA30上提取的LHL_glcm_Correlation,准确率为86%,灵敏度为52%,特异度为97%。在考虑VIBE_FA10的高度纹理显著指标识别肿瘤生长前沿时获得了最佳线性回归模型(准确率89%;灵敏度93%,特异度82%)。考虑用模式识别方法测试的显著纹理指标,在识别复发时,KNN使用VIBE_FA10提取的3个纹理显著特征达到了每个结局的最佳性能(AUC为91%,准确率93%;灵敏度99%,特异度77%)。我们的结果证实了影像组学能够识别作为生物标志物的几种预后特征,这些特征可能会影响肝转移患者的治疗选择,从而获得更个性化的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa21/8909637/a30c226872a3/cancers-14-01239-g001.jpg

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