Liu Peng, Zhu Haitao, Zhu Haibin, Zhang Xiaoyan, Feng Aiwei, Zhu Xu, Sun Yingshi
Department of Radiology, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing 100142, China.
Department of Interventional Therapy, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing 100142, China.
J Transl Int Med. 2022 Apr 2;10(1):56-64. doi: 10.2478/jtim-2022-0004. eCollection 2022 Mar.
Hepatic arterial infusion chemotherapy (HAIC) is an effective treatment for advanced unresectable colorectal cancer liver metastases (CRLM). This study was conducted to predict the efficacy of HAIC in patients with unresectable CRLM by radiomics methods based on pretreatment computed tomography (CT) examinations and clinical data.
A total of 63 patients were included in this study (41 in the training group and 22 in the validation group). All these patients underwent CT examination before HAIC. During the follow-up period, CT scans and laboratory examinations were performed regularly. Eighty-five radiological features were extracted from the regions of interest (ROIs) of CT images using the PyRadiomics program. The -test and correlation were applied to select features. These features were analyzed using LASSO-Cox regression, and a linear model was developed to predict overall survival (OS).
After reducing features by -test and correlation test, seven features remained. After LASSO-Cox cross-validation, four features remained at λ = 0.232. They were gray level co-occurrence matrix (GLCM), gray level run length matrix (GLRLM), neighborhood gray tone difference matrix (NGTDM), and the location of the primary tumor. The C-index was 0.758 in the training group and 0.743 in the test group. Nomograms predicting 1-, 2-, and 3-year survival were established.
Our study demonstrates that a radiomics approach based on pretreatment CT texture analysis has the ability to predict early the outcome of HAIC in patients with advanced unresectable colorectal cancer with a high degree of accuracy and feasibility.
肝动脉灌注化疗（HAIC）是治疗晚期不可切除的结直肠癌肝转移（CRLM）的有效方法。本研究旨在通过基于治疗前计算机断层扫描（CT）检查和临床数据的放射组学方法预测HAIC对不可切除CRLM患者的疗效。
本研究共纳入63例患者（训练组41例，验证组22例）。所有患者在接受HAIC前均进行了CT检查。随访期间定期进行CT扫描和实验室检查。使用PyRadiomics程序从CT图像的感兴趣区域（ROI）提取85个放射学特征。采用t检验和相关性分析来选择特征。使用LASSO-Cox回归分析这些特征，并建立线性模型来预测总生存期（OS）。
经t检验和相关性检验减少特征后，保留了7个特征。经过LASSO-Cox交叉验证，在λ = 0.232时保留了4个特征。它们分别是灰度共生矩阵（GLCM）、灰度游程长度矩阵（GLRLM）、邻域灰度差矩阵（NGTDM）以及原发肿瘤的位置。训练组的C指数为0.758，测试组为0.743。建立了预测1年、2年和3年生存率的列线图。
我们的研究表明，基于治疗前CT纹理分析的放射组学方法能够高度准确且可行地早期预测晚期不可切除结直肠癌患者HAIC的疗效。
