Liu Nan, Wan Yidong, Tong Yifan, He Jie, Xu Shufeng, Hu Xi, Luo Chen, Xu Lei, Guo Feng, Shen Bo, Yu Hong
Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Center of Severe Pancreatitis, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Gastroenterol Res Pract. 2023 Aug 17;2023:2831024. doi: 10.1155/2023/2831024. eCollection 2023.
Persistent organ failure (POF) is the leading cause of death in patients with acute necrotizing pancreatitis (ANP). Although several risk factors have been identified, there remains a lack of efficient instruments to accurately predict the incidence of POF in ANP.
Retrospectively, the clinical and imaging data of 178 patients with ANP were collected from our database, and the patients were divided into training ( = 125) and validation ( = 53) cohorts. Through computed tomography image acquisition, the volume of interest segmentation, and feature extraction and selection, a pure radiomics model in terms of POF prediction was established. Then, a clinic-radiomics model integrating the pure radiomics model and clinical risk factors was constructed. Both primary and secondary endpoints were compared between the high- and low-risk groups stratified by the clinic-radiomics model.
According to the 547 selected radiomics features, four models were derived from features. A clinic-radiomics model in the training and validation sets showed better predictive performance than pure radiomics and clinical models. The clinic-radiomics model was evaluated by the ratios of intervention and mechanical ventilation, intensive care unit (ICU) stays, and hospital stays. The results showed that the high-risk group had significantly higher intervention rates, ICU stays, and hospital stays than the low-risk group, with the confidence interval of 90% ( < 0.1 for all).
This clinic-radiomics model is a useful instrument for clinicians to evaluate the incidence of POF, facilitating patients' and their families' understanding of the ANP prognosis.
持续性器官衰竭（POF）是急性坏死性胰腺炎（ANP）患者死亡的主要原因。尽管已确定了多种风险因素，但仍缺乏有效手段来准确预测ANP患者中POF的发生率。
回顾性地从我们的数据库中收集了178例ANP患者的临床和影像数据，并将患者分为训练组（n = 125）和验证组（n = 53）。通过计算机断层扫描图像采集、感兴趣区分割以及特征提取与选择，建立了一个用于预测POF的纯放射组学模型。然后，构建了一个整合纯放射组学模型和临床风险因素的临床-放射组学模型。比较了根据临床-放射组学模型分层的高风险组和低风险组之间的主要和次要终点。
根据筛选出的547个放射组学特征，从这些特征中得出了四个模型。训练集和验证集中的临床-放射组学模型显示出比纯放射组学模型和临床模型更好的预测性能。通过干预和机械通气的比例、重症监护病房（ICU）住院时间以及住院时间对临床-放射组学模型进行评估。结果显示，高风险组的干预率、ICU住院时间和住院时间显著高于低风险组，90%置信区间（所有均P < 0.1）。
这种临床-放射组学模型是临床医生评估POF发生率的有用工具，有助于患者及其家属了解ANP的预后。
