基于影像组学联合弥散张量成像对 HIV 相关神经认知障碍的早期诊断价值

Value of Radiomic Analysis Combined With Diffusion Tensor Imaging in Early Diagnosis of HIV-Associated Neurocognitive Disorders.

机构信息

Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China.

出版信息

J Magn Reson Imaging. 2023 Dec;58(6):1882-1891. doi: 10.1002/jmri.28741. Epub 2023 Apr 29.

DOI:10.1002/jmri.28741

PMID:37118972

Abstract

BACKGROUND

The combination of radiomics and diffusion tensor imaging (DTI) may have potential clinical value in the early stage of HIV-associated neurocognitive disorders (HAND).

PURPOSE

To investigate the value of DTI-based radiomics in the early stage of HAND in people living with HIV (PLWH).

STUDY TYPE

Retrospective.

POPULATION

A total of 138 male PLWH were included, including 68 with intact cognition (IC) and 70 with asymptomatic neurocognitive impairment (ANI). Seventy healthy controls (HCs) were recruited for tract-based spatial statistics (TBSS) analysis. All PLWHs were randomly divided into training and validation cohorts at a 7:3 ratio.

FIELD STRENGTH/SEQUENCE: A 3 T, single-shot spin-echo echo planar imaging (EPI).

ASSESSMENT

The differences between the PLWH groups were compared using TBSS and region of interest (ROI) analysis. Radiomic features were extracted from the corpus callosum (CC) on DTI postprocessed images, including fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD). The performance of the radiomic signatures was evaluated by ROC curve analysis. The radiomic signature with the highest area under the curve (AUC) was combined with clinical characteristics to construct a nomogram. Decision curve analysis (DCA) was performed to evaluate the ability of different methods in discriminating ANI.

STATISTICAL TESTS

Chi-square test, independent-samples t test, Kruskal-Wallis test, Mann-Whitney U test, threshold-free cluster enhancement (TFCE), ROC curve analysis, DCA, multivariate logistic regression analysis, Hosmer-Lemeshow test. P < 0.05 with TFCE corrected and P < 0.0001 without TFCE corrected were considered statistically significant.

RESULTS

The ANI group showed lower FA and higher AD than the IC group. In the validation cohort, the AUCs of the FA-, AD-, MD- and RD-based radiomic signatures and the clinicoradiomic nomogram were 0.829, 0.779, 0.790, 0.864, and 0.874, respectively. DCA revealed that the nomogram was of greater clinical value than TBSS analysis, the clinical models, and the RD-based radiomic signature.

DATA CONCLUSION

The combination of DTI and radiomics is correlated with early stage of HAND in PLWH.

EVIDENCE LEVEL

TECHNICAL EFFICACY

Stage 2.

摘要

背景

放射组学与弥散张量成像（DTI）相结合可能在 HIV 相关神经认知障碍（HAND）的早期阶段具有潜在的临床价值。

目的

探讨 DTI 放射组学在 HIV 感染者（PLWH）HAND 早期阶段的价值。

研究类型

回顾性研究。

人群

共纳入 138 名男性 PLWH，包括 68 名认知正常（IC）和 70 名无症状神经认知障碍（ANI）患者。招募了 70 名健康对照（HC）进行基于束的空间统计学（TBSS）分析。所有 PLWH 随机以 7:3 的比例分为训练和验证队列。

磁场强度/序列：3T，单次激发自旋回波回波平面成像（EPI）。

评估

采用 TBSS 和感兴趣区（ROI）分析比较 PLWH 组之间的差异。从 DTI 后处理图像的胼胝体（CC）中提取放射组学特征，包括各向异性分数（FA）、轴向扩散系数（AD）、平均扩散系数（MD）和径向扩散系数（RD）。通过 ROC 曲线分析评估放射组学特征的性能。选择具有最高曲线下面积（AUC）的放射组学特征与临床特征相结合构建列线图。决策曲线分析（DCA）用于评估不同方法在鉴别 ANI 中的能力。

统计学检验

卡方检验、独立样本 t 检验、Kruskal-Wallis 检验、Mann-Whitney U 检验、无阈值聚类增强（TFCE）、ROC 曲线分析、DCA、多变量逻辑回归分析、Hosmer-Lemeshow 检验。TFCE 校正后 P<0.05 和未校正 TFCE 后 P<0.0001 被认为具有统计学意义。

结果

ANI 组 FA 低于 IC 组，AD 高于 IC 组。在验证队列中，FA、AD、MD 和 RD 基于放射组学特征以及临床放射组学列线图的 AUC 分别为 0.829、0.779、0.790、0.864 和 0.874。DCA 显示列线图比 TBSS 分析、临床模型和 RD 基于放射组学特征具有更高的临床价值。