Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR, China.
Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
Med Phys. 2023 Feb;50(2):958-969. doi: 10.1002/mp.16046. Epub 2022 Oct 27.
PURPOSE: Determination of reliable change of radiomics feature over time is essential and vital in delta-radiomics, but has not yet been rigorously examined. This study attempts to propose a methodological approach using reliable change index (RCI), a statistical metric to determine the reliability of quantitative biomarker changes by accounting for the baseline measurement standard error, in delta-radiomics. The use of RCI was demonstrated with the MRI data acquired from a group of prostate cancer (PCa) patients treated by 1.5 T MRI-guided radiotherapy (MRgRT). METHODS: Fifty consecutive PCa patients who underwent five-fractionated MRgRT were retrospectively included, and 1023 radiomics features were extracted from the clinical target volume (CTV) and planning target volume (PTV). The two MRI datasets acquired at the first fraction (MRI11 and MRI21) were used to calculate the baseline feature reliability against image acquisition using intraclass correlation coefficient (ICC). The RCI was constructed based on the baseline feature measurement standard deviation, ICC, and feature value differences at two time points between the fifth (MRI51) and the first fraction MRI (MRI11). The reliable change of features was determined in each patient only if the calculated RCI was over 1.96 or smaller than -1.96. The feature changes between MRI51 and MRI11 were correlated to two patient-reported quality-of-life clinical endpoints of urinary domain summary score (UDSS) and bowel domain summary score (BDSS) in 35 patients using the Spearman correlation test. Only the significant correlations between a feature that was reliably changed in ≥7 patients (20%) by RCI and an endpoint were considered as true significant correlations. RESULTS: The 352 (34.4%) and 386 (37.7%) features among all 1023 features were determined by RCI to be reliably changed in more than five (10%) patients in the CTV and PTV, respectively. Nineteen features were found reliably changed in the CTV and 31 features in the PTV, respectively, in 10 (20%) or more patients. These features were not necessarily associated with significantly different longitudinal feature values (group p-value < 0.05). Most reliably changed features in more than 10 patients had excellent or good baseline test-retest reliability ICC, while none showed poor reliability. The RCI method ruled out the features to be reliably changed when substantial feature measurement bias was presented. After applying the RCI criterion, only four and five true significant correlations were confirmed with UDSS and BDSS in the CTV, respectively, with low true significance correlation rates of 10.8% (4/37) and 17.9% (5/28). No true significant correlations were found in the PTV. CONCLUSIONS: The RCI method was proposed for delta-radiomics and demonstrated using PCa MRgRT data. The RCI has advantages over some other statistical metrics commonly used in the previous delta-radiomics studies, and is useful to reliably identify the longitudinal radiomics feature change on an individual basis. This proposed RCI method should be helpful for the development of essential feature selection methodology in delta-radiomics.
目的:在 delta-radiomics 中,确定随时间变化的放射组学特征的可靠变化至关重要,但尚未得到严格检验。本研究试图提出一种使用可靠变化指数(RCI)的方法,该方法是一种统计指标,通过考虑基线测量标准误差来确定定量生物标志物变化的可靠性,用于 delta-radiomics。使用 RCI 演示了从一组接受 1.5 T MRI 引导放疗(MRgRT)治疗的前列腺癌(PCa)患者获得的 MRI 数据。
方法:回顾性纳入 50 例连续接受五部分分次 MRgRT 的 PCa 患者,从临床靶区(CTV)和计划靶区(PTV)中提取 1023 个放射组学特征。使用组内相关系数(ICC)计算第一次分割(MRI11 和 MRI21)时从两个 MRI 数据集获得的基线特征对图像采集的可靠性。基于基线特征测量标准差、ICC 和两个时间点(第五次(MRI51)和第一次分割 MRI(MRI11))之间的特征值差异构建 RCI。只有在计算的 RCI 大于 1.96 或小于-1.96 的情况下,才能确定每个患者特征的可靠变化。使用 Spearman 相关检验在 35 例患者中,将 MRI51 和 MRI11 之间的特征变化与两个患者报告的生活质量临床终点(尿域综合评分(UDSS)和肠域综合评分(BDSS))相关联。仅当 RCI 确定≥7 名(20%)患者中存在可靠变化的特征与终点之间存在显著相关性时,才认为该相关性是真正显著的。
结果:在所有 1023 个特征中,有 352 个(34.4%)和 386 个(37.7%)特征分别通过 RCI 确定在 CTV 和 PTV 中分别有超过 5 个(10%)患者发生可靠变化。在 CTV 和 PTV 中分别有 19 个和 31 个特征被确定为可靠变化,分别有 10 个(20%)或更多患者。这些特征的纵向特征值不一定存在显著差异(组 p 值<0.05)。大多数在 10 名以上患者中可靠变化的特征具有极好或良好的基线测试-重测可靠性 ICC,而无一表现出较差的可靠性。当存在明显的特征测量偏倚时,RCI 方法排除了可靠变化的特征。应用 RCI 标准后,仅在 CTV 中分别确认了与 UDSS 和 BDSS 有 4 个和 5 个真正显著的相关性,其真正显著相关性的比率分别为 10.8%(4/37)和 17.9%(5/28)。在 PTV 中未发现真正显著的相关性。
结论:提出了一种用于 delta-radiomics 的 RCI 方法,并使用 PCa MRgRT 数据进行了演示。与 delta-radiomics 研究中常用的其他一些统计指标相比,RCI 具有优势,有助于在个体基础上可靠地识别纵向放射组学特征变化。该提出的 RCI 方法应有助于 delta-radiomics 中基本特征选择方法的发展。
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