Department of Hepatopancreatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Xihong Road 312, Fuzhou, 350025, China.
Department of Radiology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China.
BMC Cancer. 2023 Oct 17;23(1):991. doi: 10.1186/s12885-023-11096-7.
The purpose of this study was to develop and validate a radiomics nomogram for predicting thymidylate synthase (TYMS) status in hepatocellular carcinoma (HCC) by using Gd-DTPA contrast enhanced MRI.
We retrospectively enrolled 147 consecutive patients with surgically confirmed HCC and randomly allocated to training and validation set (7:3). The TYMS status was immunohistochemical determined and classified into low TYMS (positive cells ≤ 25%) and high TYMS (positive cells > 25%) groups. Radiomics features were extracted from the arterial phases and portal venous phase of Gd-DTPA contrast enhanced MRI. Least absolute shrinkage and selection operator (LASSO) were applied for generating the Rad score. Clinical data and MRI findings were assessed to build a clinical model. Rad score combined with clinical features was used to construct radiomics nomogram.
A total of 2260 features were extracted and reduced to 7 features as the most important discriminators to build the Rad score. InAFP was identified as the only independent clinical factors for TYMS status. The radiomics nomogram showed good discrimination in training (AUC, 0.759; 95% CI 0.665-0.838) and validation set (AUC, 0.739; 95% CI 0.585-0.860), and showed better discrimination capability (P < 0.05) compared with clinical model in training (AUC, 0.656; 95% CI 0.555-0.746) and validation set (AUC, 0.622; 95% CI 0.463-0.764).
The radiomics nomogram shows favorable predictive efficacy for TYMS status in HCC, which might be helpful for the personalized treatment of HCC.
本研究旨在通过 Gd-DTPA 对比增强 MRI 建立并验证一种用于预测肝细胞癌（HCC）胸苷酸合成酶（TYMS）状态的放射组学列线图。
我们回顾性纳入了 147 例经手术证实的 HCC 患者，并将其随机分配至训练集和验证集（7:3）。通过免疫组织化学检测 TYMS 状态，并将其分为低 TYMS（阳性细胞≤25%）和高 TYMS（阳性细胞>25%）组。从 Gd-DTPA 对比增强 MRI 的动脉期和门静脉期提取放射组学特征。采用最小绝对值收缩和选择算子（LASSO）生成 Rad 评分。评估临床数据和 MRI 结果以建立临床模型。将 Rad 评分与临床特征相结合，构建放射组学列线图。
共提取了 2260 个特征，并将其简化为 7 个最重要的判别特征来构建 Rad 评分。在 AFP 被确定为 TYMS 状态的唯一独立临床因素。放射组学列线图在训练集（AUC：0.759；95%CI：0.665-0.838）和验证集（AUC：0.739；95%CI：0.585-0.860）中均具有良好的判别能力，且在训练集（AUC：0.656；95%CI：0.555-0.746）和验证集（AUC：0.622；95%CI：0.463-0.764）中均优于临床模型（P<0.05）。
放射组学列线图对 HCC 中 TYMS 状态具有良好的预测效能，可能有助于 HCC 的个体化治疗。
