基于影像组学的肝细胞癌微血管侵犯术前评估的Meta分析
Radiomics for the Preoperative Evaluation of Microvascular Invasion in Hepatocellular Carcinoma: A Meta-Analysis.
作者信息
Li Liujun, Wu Chaoqun, Huang Yongquan, Chen Jiaxin, Ye Dalin, Su Zhongzhen
机构信息
Department of Ultrasound, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
出版信息
Front Oncol. 2022 Apr 7;12:831996. doi: 10.3389/fonc.2022.831996. eCollection 2022.
BACKGROUND
Microvascular invasion (MVI) is an independent risk factor for postoperative recurrence of hepatocellular carcinoma (HCC). To perform a meta-analysis to investigate the diagnostic performance of radiomics for the preoperative evaluation of MVI in HCC and the effect of potential factors.
MATERIALS AND METHODS
A systematic literature search was performed in PubMed, Embase, and the Cochrane Library for studies focusing on the preoperative evaluation of MVI in HCC with radiomics methods. Data extraction and quality assessment of the retrieved studies were performed. Statistical analysis included data pooling, heterogeneity testing and forest plot construction. Meta-regression and subgroup analyses were performed to reveal the effect of potential explanatory factors [design, combination of clinical factors, imaging modality, number of participants, and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) applicability risk] on the diagnostic performance.
RESULTS
Twenty-two studies with 4,129 patients focusing on radiomics for the preoperative prediction of MVI in HCC were included. The pooled sensitivity, specificity and area under the receiver operating characteristic curve (AUC) were 84% (95% CI: 81, 87), 83% (95% CI: 78, 87) and 0.90 (95% CI: 0.87, 0.92). Substantial heterogeneity was observed among the studies (=94%, 95% CI: 88, 99). Meta-regression showed that all investigative covariates contributed to the heterogeneity in the sensitivity analysis ( < 0.05). Combined clinical factors, MRI, CT and number of participants contributed to the heterogeneity in the specificity analysis ( < 0.05). Subgroup analysis showed that the pooled sensitivity, specificity and AUC estimates were similar among studies with CT or MRI.
CONCLUSION
Radiomics is a promising noninvasive method that has high preoperative diagnostic performance for MVI status. Radiomics based on CT and MRI had a comparable predictive performance for MVI in HCC. Prospective, large-scale and multicenter studies with radiomics methods will improve the diagnostic power for MVI in the future.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259363, identifier CRD42021259363.
背景
微血管侵犯（MVI）是肝细胞癌（HCC）术后复发的独立危险因素。进行一项荟萃分析，以研究放射组学对HCC中MVI术前评估的诊断性能以及潜在因素的影响。
材料与方法
在PubMed、Embase和Cochrane图书馆中进行系统的文献检索，以查找专注于用放射组学方法对HCC中MVI进行术前评估的研究。对检索到的研究进行数据提取和质量评估。统计分析包括数据合并、异质性检验和森林图构建。进行Meta回归和亚组分析，以揭示潜在解释因素[设计、临床因素组合、成像方式、参与者数量以及诊断准确性研究质量评估2（QUADAS - 2）适用性风险]对诊断性能的影响。
结果
纳入了22项研究，共4129例患者，这些研究聚焦于用放射组学对HCC中MVI进行术前预测。汇总的灵敏度、特异度和受试者操作特征曲线下面积（AUC）分别为84%（95%CI：81，87）、83%（95%CI：78，87）和0.90（95%CI：0.87，0.92）。研究间观察到显著异质性（I² = 94%，95%CI：88，99）。Meta回归显示，所有调查协变量在灵敏度分析中均导致异质性（P < 0.05）。联合临床因素、MRI、CT和参与者数量在特异度分析中导致异质性（P < 0.05）。亚组分析显示，在使用CT或MRI的研究中，汇总的灵敏度、特异度和AUC估计值相似。
结论
放射组学是一种有前景的非侵入性方法，对MVI状态具有较高的术前诊断性能。基于CT和MRI的放射组学对HCC中MVI具有可比的预测性能。未来采用放射组学方法进行的前瞻性、大规模和多中心研究将提高对MVI的诊断能力。
系统评价注册
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259363，标识符CRD42021259363。
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