Department of Radiology, Jinshan Hospital, Fudan University, Shanghai 201508, China (Q.B., J.Y., J.Q.); Department of MRI, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan 650032, China (Q.B.).
Department of Medical Oncology, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan 650032, China (K.M.).
Acad Radiol. 2024 Jun;31(6):2367-2380. doi: 10.1016/j.acra.2023.11.038. Epub 2023 Dec 21.
This study aims to explore the feasibility of MRI-based habitat radiomics for predicting response of platinum-based chemotherapy in patients with high-grade serous ovarian carcinoma (HGSOC), and compared to conventional radiomics and deep learning models.
A retrospective study was conducted on HGSOC patients from three hospitals. K-means algorithm was used to perform clustering on T2-weighted images (T2WI), contrast-enhanced T1-weighted images (CE-T1WI), and apparent diffusion coefficient (ADC) maps. After feature extraction and selection, the radiomics model, habitat model, and deep learning model were constructed respectively to identify platinum-resistant and platinum-sensitive patients. A nomogram was developed by integrating the optimal model and clinical independent predictors. The model performance and benefit was assessed using the area under the receiver operating characteristic curve (AUC), net reclassification index (NRI), and integrated discrimination improvement (IDI).
A total of 394 eligible patients were incorporated. Three habitats were clustered, a significant difference in habitat 2 (weak enhancement, high ADC values, and moderate T2WI signal) was found between the platinum-resistant and platinum-sensitive groups (P < 0.05). Compared to the radiomics model (0.640) and deep learning model (0.603), the habitat model had a higher AUC (0.710). The nomogram, combining habitat signatures with a clinical independent predictor (neoadjuvant chemotherapy), yielded a highest AUC (0.721) among four models, with positive NRI and IDI.
MRI-based habitat radiomics had the potential to predict response of platinum-based chemotherapy in patients with HGSOC. The nomogram combining with habitat signature had a best performance and good model gains for identifying platinum-resistant patients.
本研究旨在探索基于 MRI 的肿瘤生态放射组学预测高级别浆液性卵巢癌(HGSOC)患者铂类化疗反应的可行性,并与传统放射组学和深度学习模型进行比较。
对来自三家医院的 HGSOC 患者进行回顾性研究。使用 K-均值算法对 T2 加权图像(T2WI)、增强 T1 加权图像(CE-T1WI)和表观扩散系数(ADC)图进行聚类。在提取和选择特征后,分别构建放射组学模型、肿瘤生态模型和深度学习模型,以识别铂耐药和铂敏感患者。通过整合最佳模型和临床独立预测因子,开发列线图。使用受试者工作特征曲线下面积(AUC)、净重新分类指数(NRI)和综合判别改善(IDI)评估模型性能和获益。
共纳入 394 例符合条件的患者。聚类出 3 个肿瘤生态,铂耐药组和铂敏感组之间肿瘤生态 2(弱强化、高 ADC 值和中度 T2WI 信号)存在显著差异(P<0.05)。与放射组学模型(0.640)和深度学习模型(0.603)相比,肿瘤生态模型具有更高的 AUC(0.710)。列线图结合肿瘤生态标志物和临床独立预测因子(新辅助化疗),四个模型中 AUC 最高(0.721),具有阳性 NRI 和 IDI。
基于 MRI 的肿瘤生态放射组学有可能预测 HGSOC 患者铂类化疗的反应。结合肿瘤生态标志物的列线图在识别铂耐药患者方面具有最佳性能和良好的模型增益。