Shen Li, Huang Xiao, Liu YuYao, Li QingXue, Bai ShanWei, Wang Fang, Yang Quan
Department of Radiology, The Affiliated Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Oncol. 2024 Nov 20;14:1499387. doi: 10.3389/fonc.2024.1499387. eCollection 2024.
To evaluate the effectiveness of high-intensity focused ultrasound (HIFU) therapy for treating uterine fibroids by utilizing multi-sequence magnetic resonance imaging radiomic models.
One hundred and fifty patients in our hospital were randomly divided into a training cohort (n=120) and an internal test cohort (n=30), and forty-five patients from another hospital serving as an external test cohort. Radiomics features of uterine fibroids were extracted and selected based on preoperative T2-weighted imaging fat suppression(T2WI-FS)and contrast-enhanced T1WI(CE-T1WI)images, and logistic regression was used to develop the T2WI-FS, CE-T1WI, and combined T2WI-FS + CE-T1WI models, along with the radiomics-clinical model integrating radiomics features with imaging characteristics. The performance and clinical applicability of each model were assessed through receiver operating characteristic (ROC) curve, decision curve analysis (DCA), as well as Network Readiness Index (NRI) and Integrated Discrimination Index (IDI).
The AUC values of the radiomics-clinical model and the T2WI-FS + CE-T1WI model were the highest. In the training cohort, the radiomics-clinical model showed higher AUC values than the T2WI-FS + CE-T1WI model, while in the internal and external testing cohorts, the AUC values of the T2WI-FS + CE-T1WI model were higher than that of the radiomics-clinical model. DCA further demonstrated that these two models achieved the greatest net benefit. NRI and IDI analyses suggested that the T2WI-FS + CE-T1WI model had higher clinical utility.
Both the T2WI-FS + CE-T1WI model and the radiomics-clinical model demonstrate higher predictive value and larger net benefit compared to other models.
利用多序列磁共振成像放射组学模型评估高强度聚焦超声（HIFU）治疗子宫肌瘤的有效性。
将我院150例患者随机分为训练队列（n = 120）和内部测试队列（n = 30），另一家医院的45例患者作为外部测试队列。基于术前T2加权成像脂肪抑制（T2WI-FS）和对比增强T1WI（CE-T1WI）图像提取并选择子宫肌瘤的放射组学特征，采用逻辑回归建立T2WI-FS、CE-T1WI以及联合T2WI-FS + CE-T1WI模型，同时建立将放射组学特征与影像特征相结合的放射组学-临床模型。通过受试者工作特征（ROC）曲线、决策曲线分析（DCA）以及网络准备指数（NRI）和综合判别指数（IDI）评估各模型的性能和临床适用性。
放射组学-临床模型和T2WI-FS + CE-T1WI模型的AUC值最高。在训练队列中，放射组学-临床模型的AUC值高于T2WI-FS + CE-T1WI模型，而在内部和外部测试队列中，T2WI-FS + CE-T1WI模型的AUC值高于放射组学-临床模型。DCA进一步表明这两个模型获得了最大的净效益。NRI和IDI分析表明T2WI-FS + CE-T1WI模型具有更高的临床效用。
与其他模型相比，T2WI-FS + CE-T1WI模型和放射组学-临床模型均显示出更高的预测价值和更大的净效益。
