Zhang Yang, Huang Zhouyang, Zhao Yanjie, Xu Jianfeng, Chen Chaoyue, Xu Jianguo
Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, GuoXue Alley, Chengdu, 610041, China; Department of Radiology, West China Hospital, Sichuan University, No. 37, GuoXue Alley, Chengdu, 610041, China.
Department of Neurosurgery, Third People's Hospital of Mianyang/Sichuan Mental Health Center, No. 109, Jianan Road, Mianyang, 621000, China.
Asian J Surg. 2024 Jul 24. doi: 10.1016/j.asjsur.2024.07.132.
Preoperative prediction of visual outcomes following pituitary adenoma surgery is challenging yet crucial for clinical decision-making. We aimed to develop models using radiomics from multiparametric MRI to predict postoperative visual outcomes.
A cohort of 152 patients with pituitary adenoma was retrospectively enrolled and divided into recovery and non-recovery groups based on visual examinations performed six months after surgery. Radiomic features of the optic chiasm were extracted from preoperative T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and contrast-enhanced T1-weighted imaging (T1CE). Predictive models were constructed using the least absolute shrinkage and selection operator wrapped with a support vector machine through five-fold cross-validation in the development cohort and evaluated in an independent test cohort. Model performance was evaluated using the area under the curve (AUC), accuracy, sensitivity, and specificity.
Four models were established based on radiomic features selected from individual or combined sequences. The AUC values of the models based on T1WI, T2WI and T1CE were 0.784, 0.724, 0.822 in the development cohort, and 0.767, 0.763, 0.794 in the independent test cohort. The multiparametric model demonstrated superior performance among the four models, with AUC of 0.851, accuracy of 0.832. sensitivity of 0.700, specificity of 0.910 in the development cohort, and AUC of 0.847, accuracy of 0.800, sensitivity of 0.882 and specificity of 0.750 in the independent test cohort.
The multiparametric model utilizing radiomics of optic chiasm outperformed single-sequence models in predicting postoperative visual recovery in patients with pituitary adenoma, serving as a novel approach for enhancing personalized treatment strategies.
垂体腺瘤手术后视觉结果的术前预测具有挑战性,但对临床决策至关重要。我们旨在利用多参数MRI的放射组学开发模型来预测术后视觉结果。
回顾性纳入152例垂体腺瘤患者,并根据术后6个月的视力检查分为恢复组和未恢复组。从术前T1加权成像(T1WI)、T2加权成像(T2WI)和对比增强T1加权成像(T1CE)中提取视交叉的放射组学特征。在开发队列中通过五折交叉验证使用最小绝对收缩和选择算子包裹支持向量机构建预测模型,并在独立测试队列中进行评估。使用曲线下面积(AUC)、准确性、敏感性和特异性评估模型性能。
基于从单个或组合序列中选择的放射组学特征建立了四个模型。在开发队列中,基于T1WI、T2WI和T1CE的模型的AUC值分别为0.784、0.724、0.822,在独立测试队列中分别为0.767、0.763、0.794。多参数模型在四个模型中表现出优越的性能,在开发队列中AUC为0.851,准确性为0.832,敏感性为0.700,特异性为0.910,在独立测试队列中AUC为0.847,准确性为0.800,敏感性为0.882,特异性为0.750。
利用视交叉放射组学的多参数模型在预测垂体腺瘤患者术后视觉恢复方面优于单序列模型,是增强个性化治疗策略的一种新方法。