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基于放射组学和临床因素的列线图预测胎盘植入谱系疾病:一种新型的开发和验证的综合模型。

Prediction of placenta accreta spectrum with nomogram combining radiomic and clinical factors: A novel developed and validated integrative model.

机构信息

Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Clinical College of The Affiliated Central Hospital, Lishui University, Lishui, China.

Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China.

出版信息

Int J Gynaecol Obstet. 2023 Aug;162(2):639-650. doi: 10.1002/ijgo.14710. Epub 2023 Mar 14.

Abstract

OBJECTIVE

To develop and validate a clinicoradiomic nomogram based on sagittal T2WI images to predict placenta accreta spectrum (PAS).

METHODS

Between October 2016 and April 2022, women suspected of PAS by ultrasound were enrolled. After taking into account exclusion criteria, 132 women were retrospectively included in the study. The variance threshold SelectKBest and the least absolute shrinkage and selection operator were applied to select radiomic features, which was further used to calculate the Rad-score. Multivariable logistic regression was used to screen clinical factor.

RESULTS

Based on 13 radiomic features, five radiomic models were constructed. A clinical factor of intraplacental T2-hypointense bands was obtained by multivariate logistic regression. The area under the curve (AUC) value of the stochastic gradient descent (SGD) radiomic model was 0.82 in the training cohort and 0.78 in the test cohort. After adding clinical factors to the SGD radiomic model, the AUC value of the clinicoradiomic model was significantly increased from 0.82 and 0.78 to 0.84 in both the training and test cohorts. The nomogram of the clinicoradiomic model was constructed, which had good performance verified by calibration and a decision curve.

CONCLUSION

The presented nomogram could be useful for predicting PAS.

摘要

目的

基于矢状 T2WI 图像开发和验证临床放射组学列线图,以预测胎盘部位滋养细胞肿瘤(PAS)谱。

方法

2016 年 10 月至 2022 年 4 月,对超声怀疑 PAS 的患者进行前瞻性研究。在考虑排除标准后,回顾性纳入 132 例患者。采用方差阈值 SelectKBest 和最小绝对收缩和选择算子(LASSO)筛选放射组学特征,并进一步计算 Rad-score。采用多变量逻辑回归筛选临床因素。

结果

基于 13 个放射组学特征,构建了 5 个放射组学模型。通过多变量逻辑回归获得了胎盘内 T2 低信号带的临床因素。随机梯度下降(SGD)放射组学模型在训练队列中的曲线下面积(AUC)值为 0.82,在测试队列中的 AUC 值为 0.78。将临床因素加入 SGD 放射组学模型后,临床放射组学模型的 AUC 值在训练和测试队列中均从 0.82 和 0.78显著增加至 0.84。构建了临床放射组学模型的列线图,其校准和决策曲线验证具有良好的性能。

结论

本研究提出的列线图可用于预测 PAS。

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