Özdemir Harun, Azamat Sena, Sam Özdemir Merve
Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, TUR.
Department of Radiology, Başakşehir Çam and Sakura City Hospital, Istanbul, TUR.
Cureus. 2023 Sep 18;15(9):e45488. doi: 10.7759/cureus.45488. eCollection 2023 Sep.
The presence of muscle invasion is an important factor in establishing a treatment strategy for bladder cancer (BCa). The aim of this study is to reveal the diagnostic performance of radiomic shape features in predicting muscle-invasive BCa.
In this study, 60 patients with histologically proven BCa who underwent a preoperative MRI were retrospectively recruited. The whole tumor volume was segmented on apparent diffusion coefficient (ADC) maps and T2W images. Afterward, the shape features of the volume of interest were extracted using PyRadiomics. Machine learning classification was performed using statistically different shape features in MATLAB (The MathWorks, Inc., Natick, Massachusetts, United States).
The findings revealed that 27 bladder cancer patients had muscle invasion, while 33 had superficial bladder cancer (53 men and seven women; mean age: 62±14). Surface area, volume, and relevant features were significantly greater in the invasive group than in the non-invasive group based on the ADC maps (P<0.05). Superficial bladder cancer had a more spherical form compared to invasive bladder cancer (P=0.05) with both imaging modalities. Flatness and elongation did not differ significantly between groups with either modality (P>0.05). Logistic regression had the highest accuracy of 83.3% (sensitivity 82.8%, specificity 84%) in assessing invasion based on the shape features of ADC maps, while K-nearest neighbors had the highest accuracy of 78.2% (sensitivity 79.1%, specificity 69.4%) in assessing invasion based on T2W images.
Shape features can be helpful in predicting muscle invasion in bladder cancer using machine learning methods.
肌肉浸润的存在是制定膀胱癌(BCa)治疗策略的重要因素。本研究旨在揭示放射组学形状特征在预测肌肉浸润性BCa中的诊断性能。
本研究回顾性纳入了60例经组织学证实为BCa且术前行MRI检查的患者。在表观扩散系数(ADC)图和T2加权图像上分割整个肿瘤体积。随后,使用PyRadiomics提取感兴趣体积的形状特征。在MATLAB(美国马萨诸塞州纳蒂克市的MathWorks公司)中使用具有统计学差异的形状特征进行机器学习分类。
结果显示,27例膀胱癌患者有肌肉浸润,33例为浅表性膀胱癌(53例男性和7例女性;平均年龄:62±14岁)。基于ADC图,浸润组的表面积、体积及相关特征显著大于非浸润组(P<0.05)。与浸润性膀胱癌相比,两种成像方式下浅表性膀胱癌的形态更接近球形(P=0.05)。两种成像方式下,两组之间的扁平度和伸长率无显著差异(P>0.05)。基于ADC图的形状特征进行评估时,逻辑回归在评估浸润方面的准确率最高,为83.3%(敏感性82.8%,特异性84%);基于T2加权图像进行评估时,K近邻法的准确率最高,为78.2%(敏感性79.1%,特异性69.4%)。
形状特征有助于使用机器学习方法预测膀胱癌的肌肉浸润情况。