Huang Dingpin, Lin Chen, Jiang Yangyang, Xin Enhui, Xu Fangyi, Gan Yi, Xu Rui, Wang Fang, Zhang Haiping, Lou Kaihua, Shi Lei, Hu Hongjie
Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Front Oncol. 2024 Mar 20;14:1348678. doi: 10.3389/fonc.2024.1348678. eCollection 2024.
OBJECTIVE: To establish a radiomics model based on intratumoral and peritumoral features extracted from pre-treatment CT to predict the major pathological response (MPR) in patients with non-small cell lung cancer (NSCLC) receiving neoadjuvant immunochemotherapy. METHODS: A total of 148 NSCLC patients who underwent neoadjuvant immunochemotherapy from two centers (SRRSH and ZCH) were retrospectively included. The SRRSH dataset (n=105) was used as the training and internal validation cohort. Radiomics features of intratumoral (T) and peritumoral regions (P1 = 0-5mm, P2 = 5-10mm, and P3 = 10-15mm) were extracted from pre-treatment CT. Intra- and inter- class correlation coefficients and least absolute shrinkage and selection operator were used to feature selection. Four single ROI models mentioned above and a combined radiomics (CR: T+P1+P2+P3) model were established by using machine learning algorithms. Clinical factors were selected to construct the combined radiomics-clinical (CRC) model, which was validated in the external center ZCH (n=43). The performance of the models was assessed by DeLong test, calibration curve and decision curve analysis. RESULTS: Histopathological type was the only independent clinical risk factor. The model CR with eight selected radiomics features demonstrated a good predictive performance in the internal validation (AUC=0.810) and significantly improved than the model T (AUC=0.810 vs 0.619, p<0.05). The model CRC yielded the best predictive capability (AUC=0.814) and obtained satisfactory performance in the independent external test set (AUC=0.768, 95% CI: 0.62-0.91). CONCLUSION: We established a CRC model that incorporates intratumoral and peritumoral features and histopathological type, providing an effective approach for selecting NSCLC patients suitable for neoadjuvant immunochemotherapy.
目的:基于治疗前CT提取的肿瘤内及瘤周特征建立放射组学模型,以预测接受新辅助免疫化疗的非小细胞肺癌(NSCLC)患者的主要病理反应(MPR)。 方法:回顾性纳入来自两个中心(SRRSH和ZCH)的148例接受新辅助免疫化疗的NSCLC患者。SRRSH数据集(n = 105)用作训练和内部验证队列。从治疗前CT中提取肿瘤内(T)和瘤周区域(P1 = 0 - 5mm,P2 = 5 - 10mm,P3 = 10 - 15mm)的放射组学特征。使用组内和组间相关系数以及最小绝对收缩和选择算子进行特征选择。通过机器学习算法建立上述四个单ROI模型和一个联合放射组学(CR:T + P1 + P2 + P3)模型。选择临床因素构建联合放射组学 - 临床(CRC)模型,并在外部中心ZCH(n = 43)中进行验证。通过DeLong检验、校准曲线和决策曲线分析评估模型的性能。 结果:组织病理学类型是唯一独立的临床危险因素。具有八个选定放射组学特征的CR模型在内部验证中表现出良好的预测性能(AUC = 0.810),并且比T模型有显著改善(AUC = 0.810对0.619,p < 0.05)。CRC模型具有最佳的预测能力(AUC = 0.814),并且在独立的外部测试集中获得了令人满意的性能(AUC = 0.768,95%CI:0.62 - 0.91)。 结论:我们建立了一个整合肿瘤内和瘤周特征以及组织病理学类型的CRC模型,为选择适合新辅助免疫化疗的NSCLC患者提供了一种有效的方法。
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