Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
BMC Med Imaging. 2023 Jul 17;23(1):93. doi: 10.1186/s12880-023-01052-z.
OBJECTIVE: In the present study, we mainly aimed to predict the expression of androgen receptor (AR) in breast cancer (BC) patients by combing radiomic features and clinicopathological factors in a non-invasive machine learning way. MATERIALS AND METHODS: A total of 48 BC patients, who were initially diagnosed by F-FDG PET/CT, were retrospectively enrolled in this study. LIFEx software was used to extract radiomic features based on PET and CT data. The most useful predictive features were selected by the LASSO (least absolute shrinkage and selection operator) regression and t-test. Radiomic signatures and clinicopathologic characteristics were incorporated to develop a prediction model using multivariable logistic regression analysis. The receiver operating characteristic (ROC) curve, Hosmer-Lemeshow (H-L) test, and decision curve analysis (DCA) were conducted to assess the predictive efficiency of the model. RESULTS: In the univariate analysis, the metabolic tumor volume (MTV) was significantly correlated with the expression of AR in BC patients (p < 0.05). However, there only existed feeble correlations between estrogen receptor (ER), progesterone receptor (PR), and AR status (p = 0.127, p = 0.061, respectively). Based on the binary logistic regression method, MTV, SHAPE_Sphericity (CT Sphericity from SHAPE), and GLCM_Contrast (CT Contrast from grey-level co-occurrence matrix) were included in the prediction model for AR expression. Among them, GLCM_Contrast was an independent predictor of AR status (OR = 9.00, p = 0.018). The area under the curve (AUC) of ROC in this model was 0.832. The p-value of the H-L test was beyond 0.05. CONCLUSIONS: A prediction model combining radiomic features and clinicopathological characteristics could be a promising approach to predict the expression of AR and noninvasively screen the BC patients who could benefit from anti-AR regimens.
目的:本研究旨在通过结合放射组学特征和临床病理因素,采用非侵入性机器学习方法,预测乳腺癌(BC)患者雄激素受体(AR)的表达。
材料与方法:回顾性纳入 48 例经 F-FDG PET/CT 初诊的 BC 患者,应用 LIFEx 软件提取基于 PET 和 CT 数据的放射组学特征。采用 LASSO(最小绝对收缩和选择算子)回归和 t 检验筛选最有预测价值的特征。采用多变量逻辑回归分析将放射组学特征和临床病理特征相结合建立预测模型。采用受试者工作特征(ROC)曲线、Hosmer-Lemeshow(H-L)检验和决策曲线分析(DCA)评估模型的预测效能。
结果:单因素分析显示,代谢肿瘤体积(MTV)与 BC 患者 AR 表达显著相关(p<0.05)。然而,雌激素受体(ER)、孕激素受体(PR)与 AR 状态之间仅存在微弱相关性(p=0.127,p=0.061)。基于二元逻辑回归方法,将 MTV、SHAPE_Sphericity(CT 球形度来自 SHAPE)和 GLCM_Contrast(CT 对比来自灰度共生矩阵)纳入 AR 表达预测模型。其中,GLCM_Contrast 是 AR 状态的独立预测因子(OR=9.00,p=0.018)。该模型的 ROC 曲线下面积(AUC)为 0.832。H-L 检验的 p 值超过 0.05。
结论:联合放射组学特征和临床病理特征的预测模型可能是预测 AR 表达的一种很有前途的方法,并且可以无创筛选可能从抗 AR 治疗方案中获益的 BC 患者。
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