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基于超声影像组学结合临床及影像特征的机器学习方法预测移植后1年肾功能

Prediction of Renal Function 1 Year After Transplantation Using Machine Learning Methods Based on Ultrasound Radiomics Combined With Clinical and Imaging Features.

作者信息

Zhu Lili, Huang Renjun, Zhou Zhiyong, Fan Qingmin, Yan Junchen, Wan Xiaojing, Zhao Xiaojun, He Yao, Dong Fenglin

机构信息

Department of Ultrasound, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, P.R. China.

Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, P.R. China.

出版信息

Ultrason Imaging. 2023 Mar;45(2):85-96. doi: 10.1177/01617346231162910. Epub 2023 Mar 18.

Abstract

Kidney transplantation is the most effective treatment for advanced chronic kidney disease (CKD). If the prognosis of transplantation can be predicted early after transplantation, it might improve the long-term survival of patients with transplanted kidneys. Currently, studies on the assessment and prediction of renal function by radiomics are limited. Therefore, the present study aimed to explore the value of ultrasound (US)-based imaging and radiomics features, combined with clinical features to develop and validate the models for predicting transplanted kidney function after 1 year (TKF-1Y) using different machine learning algorithms. A total of 189 patients were included and classified into the abnormal TKF-1Y group, and the normal TKF-1Y group based on their estimated glomerular filtration rate (eGFR) levels 1 year after transplantation. The radiomics features were derived from the US images of each case. Three machine learning methods were employed to establish different models for predicting TKF-1Y using selected clinical and US imaging as well as radiomics features from the training set. Two US imaging, four clinical, and six radiomics features were selected. Then, the clinical (including clinical and US image features), radiomics, and combined models were developed. The area under the curves (AUCs) of the models was 0.62 to 0.82 within the test set. Combined models showed statistically higher AUCs than the radiomics models (all -values <.05). The prediction performance of different models was not significantly affected by the different machine learning algorithms (all -values >.05). In conclusion, US imaging features combined with clinical features could predict TKF-1Y and yield an incremental value over radiomics features. A model integrating all available features may further improve the predictive efficacy. Different machine learning algorithms may not have a significant impact on the predictive performance of the model.

摘要

肾移植是晚期慢性肾脏病(CKD)最有效的治疗方法。如果能在肾移植后早期预测移植预后,可能会提高肾移植患者的长期生存率。目前,基于影像组学评估和预测肾功能的研究有限。因此,本研究旨在探讨基于超声(US)的影像学和影像组学特征,结合临床特征,使用不同机器学习算法开发并验证预测移植肾1年后肾功能(TKF - 1Y)的模型。共纳入189例患者,根据移植后1年的估计肾小球滤过率(eGFR)水平分为TKF - 1Y异常组和TKF - 1Y正常组。影像组学特征来自每个病例的US图像。采用三种机器学习方法,利用训练集的选定临床、US影像以及影像组学特征建立不同的预测TKF - 1Y的模型。选择了两个US影像特征、四个临床特征和六个影像组学特征。然后,开发了临床(包括临床和US图像特征)、影像组学和联合模型。在测试集中,模型的曲线下面积(AUC)为0.62至0.82。联合模型的AUC在统计学上高于影像组学模型(所有P值<.05)。不同机器学习算法对不同模型的预测性能没有显著影响(所有P值>.05)。总之,US影像特征与临床特征相结合可以预测TKF - 1Y,并且比影像组学特征具有更高的价值。整合所有可用特征的模型可能会进一步提高预测效果。不同的机器学习算法可能对模型的预测性能没有显著影响。

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