Chang Cheng, Ruan Maomei, Lei Bei, Yu Hong, Zhao Wenlu, Ge Yaqiong, Duan Shaofeng, Teng Wenjing, Wu Qianfu, Qian Xiaohua, Wang Lihua, Yan Hui, Liu Ciyi, Liu Liu, Feng Jian, Xie Wenhui
Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Road, Shanghai, 200030, China.
Clinical and Translational Center in Shanghai Chest Hospital, Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.
EJNMMI Res. 2022 Apr 21;12(1):23. doi: 10.1186/s13550-022-00895-x.
To investigate the value of F-FDG PET/CT molecular radiomics combined with a clinical model in predicting thoracic lymph node metastasis (LNM) in invasive lung adenocarcinoma (≤ 3 cm).
A total of 528 lung adenocarcinoma patients were enrolled in this retrospective study. Five models were developed for the prediction of thoracic LNM, including PET radiomics, CT radiomics, PET/CT radiomics, clinical and integrated PET/CT radiomics-clinical models. Ten PET/CT radiomics features and two clinical characteristics were selected for the construction of the integrated PET/CT radiomics-clinical model. The predictive performance of all models was examined by receiver operating characteristic (ROC) curve analysis, and clinical utility was validated by nomogram analysis and decision curve analysis (DCA).
According to ROC curve analysis, the integrated PET/CT molecular radiomics-clinical model outperformed the clinical model and the three other radiomics models, and the area under the curve (AUC) values of the integrated model were 0.95 (95% CI: 0.93-0.97) in the training group and 0.94 (95% CI: 0.89-0.97) in the test group. The nomogram analysis and DCA confirmed the clinical application value of this integrated model in predicting thoracic LNM.
The integrated PET/CT molecular radiomics-clinical model proposed in this study can ensure a higher level of accuracy in predicting the thoracic LNM of clinical invasive lung adenocarcinoma (≤ 3 cm) compared with the radiomics model or clinical model alone.
探讨¹⁸F-氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（¹⁸F-FDG PET/CT）分子影像组学联合临床模型预测≤3 cm的浸润性肺腺癌胸段淋巴结转移（LNM）的价值。
本回顾性研究共纳入528例肺腺癌患者。构建了5种预测胸段LNM的模型，包括PET影像组学、CT影像组学、PET/CT影像组学、临床模型以及PET/CT影像组学-临床整合模型。选取10个PET/CT影像组学特征和2个临床特征构建PET/CT影像组学-临床整合模型。采用受试者操作特征（ROC）曲线分析检验所有模型的预测性能，并通过列线图分析和决策曲线分析（DCA）验证临床实用性。
根据ROC曲线分析，PET/CT分子影像组学-临床整合模型优于临床模型和其他3种影像组学模型，整合模型在训练组的曲线下面积（AUC）值为0.95（95%CI：0.93-0.97），在测试组为0.94（95%CI：0.89-0.97）。列线图分析和DCA证实了该整合模型在预测胸段LNM方面的临床应用价值。
本研究提出的PET/CT分子影像组学-临床整合模型在预测临床浸润性肺腺癌（≤3 cm）胸段LNM方面，与单独的影像组学模型或临床模型相比，能确保更高的准确性。
