Mao H Y, Yu Y X, Zhang J Y, Zhang T, Fan Y F, Hu S, Wang X M, Hu C H
Department of Radiology, the First Affiliated Hospital of Soochow University, Institute of Medical Imaging of Soochow University, Suzhou 215006, China.
Department of Radiology, Nantong No.3 People's Hospital, Nantong 226000, China.
Zhonghua Yi Xue Za Zhi. 2023 Sep 5;103(33):2599-2606. doi: 10.3760/cma.j.cn112137-20230117-00095.
To investigate the application value of Gd-EOB-DTPA enhanced MRI based radiomics model in the differential diagnosis of iso-or hyperintensity HCC and focal nodular hyperplasia (FNH) in hepatobiliary phase. A total of 88 patients with HCC or FNH confirmed by surgical or puncture pathology who underwent preoperative Gd-EOB-DTPA enhanced MRI (all lesions showed iso-or hyperintensity in hepatobiliary phase) between January 2015 and February 2023 in The First Affiliated Hospital of Soochow University and Nantong No.3 People's Hospital were retrospectively evaluated, which including 58 males and 30 females, aged [(]56 (40, 67) years, including 61 patients with HCC and 27 patients with FNH. The included cases were divided into training (43 cases of HCC, 19 cases of FNH) and validation cohort (18 cases of HCC, 8 cases of FNH) in the ratio of 7∶3 using the random seeding method. A total of 1 781 radiomics features were extracted from Gd-EOB-DTPA enhanced MRI in the arterial, portal and hepatobiliary phases, respectively. The independent three phase models, combined three phases model and combined clinical-radiomics model was established using Auto-Encoder (AE) and Native Bayes (NB) classifier, respectively. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of these models. DeLong test was used to compare the areas under curve (AUC). In the validation cohort, the combined clinical-radiomics model had the highest AUC (AUC=0.938, 95%: 0.828-1.000). The AUC, accuracy, sensitivity, specificity of the clinical-radiomics combined model using AE classifier in the validation cohort were 0.896 (95%: 0.760-1.000), 88.5%, 88.9%, 87.5%. The AUC of the clinical-radiomics combined model using NB classifier in the validation cohort were 0.938 (95%: 0.828-1.000), 92.3%, 88.9%, 100.0%. Gd-EOB-DTPA enhanced MRI combined clinical-radiomics model has certain value in preoperative differentiation of iso-or hyperintensity in the hepatobiliary phase HCC and FNH, with a high accuracy, sensitivity and specificity.
探讨基于钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）的影像组学模型在肝胆期等或高信号肝细胞癌（HCC）与肝局灶性结节性增生（FNH）鉴别诊断中的应用价值。回顾性分析2015年1月至2023年2月在苏州大学附属第一医院和南通市第三人民医院接受术前Gd-EOB-DTPA增强MRI检查（所有病灶在肝胆期呈等或高信号）且经手术或穿刺病理确诊为HCC或FNH的88例患者，其中男性58例，女性30例，年龄[56（40，67）岁]，包括HCC患者61例，FNH患者27例。采用随机种子法将纳入病例按7∶3的比例分为训练组（HCC 43例，FNH 19例）和验证组（HCC 18例，FNH 8例）。分别从Gd-EOB-DTPA增强MRI的动脉期、门脉期和肝胆期提取1781个影像组学特征。分别使用自动编码器（AE）和朴素贝叶斯（NB）分类器建立独立三期模型、联合三期模型和联合临床-影像组学模型。采用受试者操作特征（ROC）曲线评估这些模型的诊断性能。使用德龙检验比较曲线下面积（AUC）。在验证组中，联合临床-影像组学模型的AUC最高（AUC = 0.938，95%：0.828 - 1.000）。验证组中使用AE分类器的临床-影像组学联合模型的AUC、准确率、灵敏度、特异度分别为0.896（95%：0.760 - 1.000）、88.5%、88.9%、87.5%。验证组中使用NB分类器的临床-影像组学联合模型的AUC为0.938（95%：0.828 - 1.000）、92.3%、88.9%、100.0%。Gd-EOB-DTPA增强MRI联合临床-影像组学模型在术前鉴别肝胆期等或高信号HCC与FNH中具有一定价值，具有较高的准确率、灵敏度和特异度。
