School of Medical Imaging, Tianjin Medical University, No.1, Guangdong Road, Hexi District, Tianjin, 300203, China.
Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
BMC Med Imaging. 2024 Apr 12;24(1):87. doi: 10.1186/s12880-024-01272-x.
Fibrosis has important pathoetiological and prognostic roles in chronic liver disease. This study evaluates the role of radiomics in staging liver fibrosis.
After literature search in electronic databases (Embase, Ovid, Science Direct, Springer, and Web of Science), studies were selected by following precise eligibility criteria. The quality of included studies was assessed, and meta-analyses were performed to achieve pooled estimates of area under receiver-operator curve (AUROC), accuracy, sensitivity, and specificity of radiomics in staging liver fibrosis compared to histopathology.
Fifteen studies (3718 patients; age 47 years [95% confidence interval (CI): 42, 53]; 69% [95% CI: 65, 73] males) were included. AUROC values of radiomics for detecting significant fibrosis (F2-4), advanced fibrosis (F3-4), and cirrhosis (F4) were 0.91 [95%CI: 0.89, 0.94], 0.92 [95%CI: 0.90, 0.95], and 0.94 [95%CI: 0.93, 0.96] in training cohorts and 0.89 [95%CI: 0.83, 0.91], 0.89 [95%CI: 0.83, 0.94], and 0.93 [95%CI: 0.91, 0.95] in validation cohorts, respectively. For diagnosing significant fibrosis, advanced fibrosis, and cirrhosis the sensitivity of radiomics was 84.0% [95%CI: 76.1, 91.9], 86.9% [95%CI: 76.8, 97.0], and 92.7% [95%CI: 89.7, 95.7] in training cohorts, and 75.6% [95%CI: 67.7, 83.5], 80.0% [95%CI: 70.7, 89.3], and 92.0% [95%CI: 87.8, 96.1] in validation cohorts, respectively. Respective specificity was 88.6% [95% CI: 83.0, 94.2], 88.4% [95% CI: 81.9, 94.8], and 91.1% [95% CI: 86.8, 95.5] in training cohorts, and 86.8% [95% CI: 83.3, 90.3], 94.0% [95% CI: 89.5, 98.4], and 88.3% [95% CI: 84.4, 92.2] in validation cohorts. Limitations included use of several methods for feature selection and classification, less availability of studies evaluating a particular radiological modality, lack of a direct comparison between radiology and radiomics, and lack of external validation.
Although radiomics offers good diagnostic accuracy in detecting liver fibrosis, its role in clinical practice is not as clear at present due to comparability and validation constraints.
纤维化在慢性肝病的病理生理学和预后中有重要作用。本研究评估了放射组学在肝纤维化分期中的作用。
在电子数据库（Embase、Ovid、Science Direct、Springer 和 Web of Science）中进行文献检索后，根据严格的纳入标准选择研究。评估纳入研究的质量，并进行荟萃分析，以获得与组织病理学相比，放射组学在分期肝纤维化方面的受试者工作特征曲线下面积（AUROC）、准确性、敏感度和特异度的汇总估计值。
共纳入 15 项研究（3718 例患者；年龄 47 岁[95%置信区间（CI）：42，53]；69%[95%CI：65，73]为男性）。放射组学检测显著纤维化（F2-4）、进展性纤维化（F3-4）和肝硬化（F4）的 AUROC 值在训练队列中分别为 0.91[95%CI：0.89，0.94]、0.92[95%CI：0.90，0.95]和 0.94[95%CI：0.93，0.96]，在验证队列中分别为 0.89[95%CI：0.83，0.91]、0.89[95%CI：0.83，0.94]和 0.93[95%CI：0.91，0.95]。对于诊断显著纤维化、进展性纤维化和肝硬化，放射组学的敏感度在训练队列中分别为 84.0%[95%CI：76.1，91.9]、86.9%[95%CI：76.8，97.0]和 92.7%[95%CI：89.7，95.7]，在验证队列中分别为 75.6%[95%CI：67.7，83.5]、80.0%[95%CI：70.7，89.3]和 92.0%[95%CI：87.8，96.1]。相应的特异度在训练队列中分别为 88.6%[95%CI：83.0，94.2]、88.4%[95%CI：81.9，94.8]和 91.1%[95%CI：86.8，95.5]，在验证队列中分别为 86.8%[95%CI：83.3，90.3]、94.0%[95%CI：89.5，98.4]和 88.3%[95%CI：84.4，92.2]。局限性包括特征选择和分类方法的使用，评估特定放射学模式的研究可用性较低，缺乏放射学和放射组学之间的直接比较，以及缺乏外部验证。
尽管放射组学在检测肝纤维化方面具有良好的诊断准确性，但由于可比性和验证限制，其在临床实践中的作用目前尚不清楚。
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