Wang Bing, Hu Tianyuan, Shen Rongfang, Liu Lian, Qiao Junwei, Zhang Rongqin, Zhang Zhanwen
The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Abdom Radiol (NY). 2025 Jan;50(1):64-77. doi: 10.1007/s00261-024-04515-1. Epub 2024 Aug 3.
This study aimed to establish a clinical nomogram model based on a radiomics signatures derived from F-fluorodeoxyglucose positron-emission tomography (F-FDG PET/CT) and clinical parameters to predict disease-free survival (DFS) in patients with stage II/III colorectal adenocarcinoma. Understanding and predicting DFS in these patients is key to optimizing treatment strategies.
A retrospective analysis included 332 cases from July 2011 to July 2021 at The Sixth Affiliated Hospital, Sun Yat-sen University, with PET/CT assessing radiomics features and clinicopathological features. Univariate Cox regression, the least absolute shrinkage and selection operator (LASSO) Cox, and multivariable Cox regression identified recurrence-related radiomics features. We used a weighted radiomics score (Rad-score) and independent risk factors to construct a nomogram. Evaluation involved time-dependent receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
The nomogram, incorporating Rad-score, pN, and pT demonstrated robust predictive ability for DFS in stage II/III colorectal adenocarcinoma. Training cohort areas under the curve (AUCs) were 0.78, 0.80, and 0.86 at 1, 2, and 3 years, respectively, and validation cohort AUCs were 0.79, 0.75, and 0.73. DCA and calibration curves affirmed the nomogram's clinical relevance.
The F-FDG PET/CT based radiomics nomogram, including Rad-score, pN, and pT, effectively predicted tumor recurrence in stage II/III colorectal adenocarcinoma, significantly enhancing prognostic stratification. Our findings highlight the potential of this nomogram as a guide for clinical decision making to improve patient outcomes.
本研究旨在基于氟脱氧葡萄糖正电子发射断层扫描（F-FDG PET/CT）得出的影像组学特征和临床参数建立一个临床列线图模型，以预测II/III期结直肠癌患者的无病生存期（DFS）。了解并预测这些患者的DFS是优化治疗策略的关键。
一项回顾性分析纳入了2011年7月至2021年7月中山大学附属第六医院的332例病例，通过PET/CT评估影像组学特征和临床病理特征。单因素Cox回归、最小绝对收缩和选择算子（LASSO）Cox回归以及多因素Cox回归确定了与复发相关的影像组学特征。我们使用加权影像组学评分（Rad-score）和独立危险因素构建列线图。评估包括时间依赖性受试者工作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）。
纳入Rad-score、pN和pT的列线图对II/III期结直肠癌的DFS显示出强大的预测能力。训练队列在1年、2年和3年时的曲线下面积（AUC）分别为0.78、0.80和0.86，验证队列的AUC分别为0.79、0.75和0.73。DCA和校准曲线证实了列线图的临床相关性。
基于F-FDG PET/CT的影像组学列线图，包括Rad-score、pN和pT，有效预测了II/III期结直肠癌的肿瘤复发，显著增强了预后分层。我们的研究结果突出了该列线图作为临床决策指南以改善患者预后的潜力。
