Department of Medical Imaging, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Thorac Cancer. 2024 Jan;15(1):23-34. doi: 10.1111/1759-7714.15151. Epub 2023 Nov 28.
BACKGROUND: To develop and validate a preoperative nomogram model combining the radiomics signature and clinical features for preoperative prediction of visceral pleural invasion (VPI) in lung nodules presenting as part-solid density. METHODS: We retrospectively reviewed 156 patients with pathologically confirmed invasive lung adenocarcinomas after surgery from January 2016 to August 2019. The patients were split into training and validation sets by a ratio of 7:3. The radiomic features were extracted with the aid of FeAture Explorer Pro (FAE). A CT-based radiomics model was constructed to predict the presence of VPI and internally validated. Multivariable regression analysis was conducted to construct a nomogram model, and the performance of the models were evaluated with the area under the receiver operating characteristic curve (AUC) and compared with each other. RESULTS: The enrolled patients were split into training (n = 109) and validation sets (n = 47). A total of 806 features were extracted and the selected 10 optimal features were used in the construction of the radiomics model among the 707 stable features. The AUC of the nomogram model was 0.888 (95% CI: 0.762-0.961), which was superior to the clinical model (0.787, 95% CI: 0.643-0.893; p = 0.049) and comparable to the radiomics model (0.879, 95% CI: 0.751-0.965; p > 0.05). The nomogram model achieved a sensitivity of 90.5% and a specificity of 76.9% in the validation dataset. CONCLUSIONS: The nomogram model could be considered as a noninvasive method to predict VPI with either highly sensitive or highly specific diagnoses depending on clinical needs.
背景:为了对表现为部分实性密度的肺结节中内脏胸膜侵犯(VPI)进行术前预测,开发并验证一种结合放射组学特征和临床特征的术前列线图模型。
方法:我们回顾性分析了 2016 年 1 月至 2019 年 8 月期间经手术病理证实的 156 例浸润性肺腺癌患者。患者按照 7:3 的比例分为训练集和验证集。借助于 FeAture Explorer Pro(FAE)提取放射组学特征。构建基于 CT 的放射组学模型来预测 VPI 的存在,并进行内部验证。进行多变量回归分析构建列线图模型,并通过接受者操作特征曲线下面积(AUC)评估模型性能,并相互比较。
结果:纳入的患者被分为训练集(n=109)和验证集(n=47)。共提取 806 个特征,在 707 个稳定特征中,选择了 10 个最优特征用于构建放射组学模型。列线图模型的 AUC 为 0.888(95%CI:0.762-0.961),优于临床模型(0.787,95%CI:0.643-0.893;p=0.049),与放射组学模型相当(0.879,95%CI:0.751-0.965;p>0.05)。在验证数据集中,列线图模型的灵敏度为 90.5%,特异性为 76.9%。
结论:该列线图模型可以作为一种非侵入性方法,根据临床需要,以高灵敏度或高特异性进行 VPI 预测。
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