The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.
Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou, 310006, People's Republic of China.
BMC Med Imaging. 2022 Jul 4;22(1):118. doi: 10.1186/s12880-022-00844-z.
Evaluating inflammatory severity using imaging is essential for Crohn's disease, but it is limited by potential interobserver variation and subjectivity. We compared the efficiency of magnetic resonance index of activity (MaRIA) collected by radiologists and a radiomics model in assessing the inflammatory severity of terminal ileum (TI).
121 patients were collected from two centers. Patients were divided into ulcerative group and mucosal remission group based on the TI Crohn's disease Endoscopic Severity Index. The consistency of bowel wall thickness (BWT), relative contrast enhancement (RCE), edema, ulcer, MaRIA and features of the region of interest between radiologists were described by weighted Kappa test and intraclass correlation coefficient (ICC), and developed receiver operating curve of MaRIA. The radiomics model was established using reproducible features of logistic regression based on arterial staging of T1WI sequences. Delong test was used to compare radiomics with MaRIA.
The consistency between radiologists were moderate in BWT (ICC = 0.638), fair in edema (κ = 0.541), RCE (ICC = 0.461), MaRIA (ICC = 0.579) and poor in ulcer (κ = 0.271). Radiomics model was developed by 6 reproducible features (ICC = 0.93-0.96) and equivalent to MaRIA which evaluated by the senior radiologist (0.872 vs 0.883 in training group, 0.824 vs 0.783 in validation group, P = 0.847, 0.471), both of which were significantly higher than MaRIA evaluated by junior radiologist (AUC: 0.621 in training group, 0.557 in validation group, all, P < 0.05).
The evaluation of inflammatory severity could be performed by radiomics objectively and reproducibly, and was comparable to MaRIA evaluated by the senior radiologist. Radiomics may be an important method to assist junior radiologists to assess the severity of inflammation objectively and accurately.
评估克罗恩病的炎症严重程度需要使用影像学，但是这种方法受到观察者间差异和主观性的限制。我们比较了放射科医生采集的磁共振活动指数（MaRIA）和放射组学模型在评估末端回肠炎（TI）炎症严重程度方面的效率。
从两个中心收集了 121 名患者。根据 TI 克罗恩病内镜严重程度指数，将患者分为溃疡性组和黏膜缓解组。采用加权 Kappa 检验和组内相关系数（ICC）描述放射科医生间肠壁厚度（BWT）、相对对比增强（RCE）、水肿、溃疡、MaRIA 和感兴趣区特征的一致性，并绘制 MaRIA 的接收者操作特征曲线。基于 T1WI 序列的动脉分期，利用可重复的特征，通过逻辑回归建立放射组学模型。采用 DeLong 检验比较放射组学与 MaRIA 的结果。
放射科医生间在 BWT（ICC=0.638）、水肿（κ=0.541）、RCE（ICC=0.461）、MaRIA（ICC=0.579）和溃疡（κ=0.271）方面的一致性为中度。通过 6 个可重复的特征（ICC=0.93-0.96）建立的放射组学模型与高级放射科医生评估的 MaRIA 相当（训练组 0.872 比 0.883，验证组 0.824 比 0.783，P=0.847，0.471），两者均显著高于初级放射科医生评估的 MaRIA（AUC：训练组 0.621，验证组 0.557，均 P<0.05）。
放射组学可以客观、可重复地评估炎症严重程度，与高级放射科医生评估的 MaRIA 相当。放射组学可能是一种重要的方法，可以帮助初级放射科医生客观、准确地评估炎症的严重程度。
