利用计算机断层扫描的影像组学优化肌层浸润性膀胱癌患者的术前淋巴结分期

Optimization of Preoperative Lymph Node Staging in Patients with Muscle-Invasive Bladder Cancer Using Radiomics on Computed Tomography.

作者信息

Starmans Martijn P A, Ho Li Shen, Smits Fokko, Beije Nick, de Kruijff Inge, de Jong Joep J, Somford Diederik M, Boevé Egbert R, Te Slaa Ed, Cauberg Evelyne C C, Klaver Sjoerd, van der Heijden Antoine G, Wijburg Carl J, van de Luijtgaarden Addy C M, van Melick Harm H E, Cauffman Ella, de Vries Peter, Jacobs Rens, Niessen Wiro J, Visser Jacob J, Klein Stefan, Boormans Joost L, van der Veldt Astrid A M

机构信息

Department of Radiology and Nuclear Medicine, Erasmus MC, 3015 GD Rotterdam, The Netherlands.

Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands.

出版信息

J Pers Med. 2022 Apr 30;12(5):726. doi: 10.3390/jpm12050726.

Approximately 25% of the patients with muscle-invasive bladder cancer (MIBC) who are clinically node negative have occult lymph node metastases at radical cystectomy (RC) and pelvic lymph node dissection. The aim of this study was to evaluate preoperative CT-based radiomics to differentiate between pN+ and pN0 disease in patients with clinical stage cT2-T4aN0-N1M0 MIBC. Patients with cT2-T4aN0-N1M0 MIBC, of whom preoperative CT scans and pathology reports were available, were included from the prospective, multicenter CirGuidance trial. After manual segmentation of the lymph nodes, 564 radiomics features were extracted. A combination of different machine-learning methods was used to develop various decision models to differentiate between patients with pN+ and pN0 disease. A total of 209 patients (159 pN0; 50 pN+) were included, with a total of 3153 segmented lymph nodes. None of the individual radiomics features showed significant differences between pN+ and pN0 disease, and none of the radiomics models performed substantially better than random guessing. Hence, CT-based radiomics does not contribute to differentiation between pN+ and pN0 disease in patients with cT2-T4aN0-N1M0 MIBC.

在接受根治性膀胱切除术（RC）和盆腔淋巴结清扫术时，临床淋巴结阴性的肌肉浸润性膀胱癌（MIBC）患者中约25%存在隐匿性淋巴结转移。本研究的目的是评估基于术前CT的影像组学，以区分临床分期为cT2-T4aN0-N1M0的MIBC患者的pN+和pN0疾病。从前瞻性多中心CirGuidance试验中纳入了术前有CT扫描和病理报告的cT2-T4aN0-N1M0 MIBC患者。在对淋巴结进行手动分割后，提取了564个影像组学特征。使用不同机器学习方法的组合来开发各种决策模型，以区分pN+和pN0疾病的患者。共纳入209例患者（159例pN0；50例pN+），共有3153个分割的淋巴结。在pN+和pN0疾病之间，没有单个影像组学特征显示出显著差异，并且没有一个影像组学模型的表现明显优于随机猜测。因此，基于CT的影像组学对cT2-T4aN0-N1M0 MIBC患者的pN+和pN0疾病的区分没有帮助。