Chang Runsheng, Qi Shouliang, Zuo Yifan, Yue Yong, Zhang Xiaoye, Guan Yubao, Qian Wei
College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.
Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China.
Front Oncol. 2022 Aug 8;12:915835. doi: 10.3389/fonc.2022.915835. eCollection 2022.
PURPOSE: This study aims to evaluate the ability of peritumoral, intratumoral, or combined computed tomography (CT) radiomic features to predict chemotherapy response in non-small cell lung cancer (NSCLC). METHODS: After excluding subjects with incomplete data or other types of treatments, 272 (Dataset 1) and 43 (Dataset 2, external validation) NSCLC patients who were only treated with chemotherapy as the first-line treatment were enrolled between 2015 and 2019. All patients were divided into response and nonresponse based on the response evaluation criteria in solid tumors, version 1.1. By using 3D slicer and morphological operations in python, the intra- and peritumoral regions of lung tumors were segmented from pre-treatment CT images (unenhanced) and confirmed by two experienced radiologists. Then radiomic features (the first order, texture, shape, et al.) were extracted from the above regions of interest. The models were trained and tested in Dataset 1 and further validated in Dataset 2. The performance of models was compared using the area under curve (AUC), confusion matrix, accuracy, precision, recall, and F1-score. RESULTS: The radiomic model using features from the peritumoral region of 0-3 mm outperformed that using features from 3-6, 6-9, 9-12 mm peritumoral region, and intratumoral region (AUC: 0.95 versus 0.87, 0.86, 0.85, and 0.88). By the fusion of features from 0-3 and 3-6 mm peritumoral regions, the logistic regression model achieved the best performance, with an AUC of 0.97. This model achieved an AUC of 0.85 in the external cohort. Moreover, among the 20 selected features, seven features differed significantly between the two groups (p < 0.05). CONCLUSIONS: CT radiomic features from both the peri- and intratumoral regions can predict chemotherapy response in NSCLC using machine learning models. Combined features from two peritumoral regions yielded better predictions.
目的:本研究旨在评估瘤周、瘤内或联合计算机断层扫描(CT)影像组学特征预测非小细胞肺癌(NSCLC)化疗反应的能力。 方法:排除数据不完整或接受其他类型治疗的受试者后,2015年至2019年间纳入了272例(数据集1)和43例(数据集2,外部验证)仅接受化疗作为一线治疗的NSCLC患者。根据实体瘤疗效评价标准1.1版,将所有患者分为反应组和无反应组。通过使用3D Slicer和Python中的形态学操作,从治疗前CT图像(平扫)中分割出肺肿瘤的瘤内和瘤周区域,并由两名经验丰富的放射科医生进行确认。然后从上述感兴趣区域提取影像组学特征(一阶、纹理、形状等)。在数据集1中对模型进行训练和测试,并在数据集2中进一步验证。使用曲线下面积(AUC)、混淆矩阵、准确性、精确性、召回率和F1分数比较模型的性能。 结果:使用0 - 3 mm瘤周区域特征的影像组学模型优于使用3 - 6、6 - 9、9 - 12 mm瘤周区域和瘤内区域特征的模型(AUC:0.95对0.87、0.86、0.85和0.88)。通过融合0 - 3和3 - 6 mm瘤周区域的特征,逻辑回归模型取得了最佳性能,AUC为0.97。该模型在外部队列中的AUC为0.85。此外,在20个选定特征中,两组之间有7个特征存在显著差异(p < 0.05)。 结论:瘤周和瘤内区域的CT影像组学特征均可使用机器学习模型预测NSCLC的化疗反应。两个瘤周区域的联合特征产生了更好的预测效果。
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