Chen Yuntian, Yuan Enyu, Sun Guangxi, Song Bin, Yao Jin
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610000, China.
Department of Urology, West China Hospital, Sichuan University, Chengdu 610017, China.
J Clin Med. 2023 Feb 6;12(4):1301. doi: 10.3390/jcm12041301.
This study aimed to develop and internally validate computed tomography (CT)-based radiomic models to predict the lesion-level short-term response to tyrosine kinase inhibitors (TKIs) in patients with advanced renal cell carcinoma (RCC).
This retrospective study included consecutive patients with RCC that were treated using TKIs as the first-line treatment. Radiomic features were extracted from noncontrast (NC) and arterial-phase (AP) CT images. The model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA).
A total of 36 patients with 131 measurable lesions were enrolled (training: validation = 91: 40). The model with five delta features achieved the best discrimination capability with AUC values of 0.940 (95% CI, 0.890‒0.990) in the training cohort and 0.916 (95% CI, 0.828‒1.000) in the validation cohort. Only the delta model was well calibrated. The DCA showed that the net benefit of the delta model was greater than that of the other radiomic models, as well as that of the treat-all and treat-none criteria.
Models based on CT delta radiomic features may help predict the short-term response to TKIs in patients with advanced RCC and aid in lesion stratification for potential treatments.
本研究旨在开发并进行内部验证基于计算机断层扫描(CT)的放射组学模型,以预测晚期肾细胞癌(RCC)患者对酪氨酸激酶抑制剂(TKIs)的病灶水平短期反应。
这项回顾性研究纳入了连续接受TKIs一线治疗的RCC患者。从平扫(NC)和动脉期(AP)CT图像中提取放射组学特征。使用受试者操作特征曲线下面积(AUC)、校准曲线和决策曲线分析(DCA)评估模型性能。
共纳入36例患者,有131个可测量病灶(训练组:验证组 = 91:40)。具有五个差值特征的模型具有最佳区分能力,训练队列中的AUC值为0.940(95%CI,0.890‒0.990),验证队列中的AUC值为0.916(95%CI,0.828‒1.000)。只有差值模型校准良好。DCA显示,差值模型的净效益大于其他放射组学模型以及全治疗和不治疗标准的净效益。
基于CT差值放射组学特征的模型可能有助于预测晚期RCC患者对TKIs的短期反应,并有助于对潜在治疗的病灶进行分层。