Li Xinyi, Tang Ziwei, Liu Yong, Du Yanni, Xing Yuxue, Zhang Zixin, Xie Ruming
Department of Radiology, Beijing Ditan Hospital, Capital Medical University, No. 8 Jingshun East Street, 100015, Beijing, Chaoyang District, China.
Department of Radiology, Changde Hospital, Xiangya School of Medicine, Central South University, 415000, Changde, China.
Radiologie (Heidelb). 2025 Feb 4. doi: 10.1007/s00117-024-01412-y.
This study aimed to assess the effectiveness of various machine learning models in identifying lymph node metastasis in colon cancer patients and to explore the potential benefits of combining clinicoradiological and radiomics features for improved diagnosis. A total of 260 patients with pathologically confirmed colon cancer were retrospectively included in study center 1 and study center 2 from January 2015 to August 2024. A total of 198 patients with colon cancer in center 1 were randomly divided into a training set (n = 138) and an internal testing set (n = 60) at a ratio of 7:3. Patients in center 2 were included in the external testing set (n = 62). Five clinical radiological features were used to establish a clinical model. Radiomics features were extracted from the computed tomography venous phase images, and four classifiers, including logistic regression, support vector machine, decision tree, and k‑nearest neighbor, were used to build machine learning models. In addition, a combined model was constructed by joining clinical, radiological, and radiogenomic features. The performance of these models was evaluated in terms of accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating curve (ROC) and calibration curves in the training set, internal testing set, and external testing set to determine the diagnostic model with the highest predictive efficiency and to evaluate the stability of the model. Among the four machine learning models, the SVM model had the best predictive performance, with an area under the ROC (AUC) of 0.813, 0.724, and 0.721 for the training set, internal testing set, and external testing set, respectively. The clinical model, radiomics model, and combined model had an AUC of 0.823, 0.813, 0.817, 0.508, 0.724, 0.751, 0.582, 0.721, and 0.744 in the training set, internal testing set, and external testing set, respectively. In conclusion, the combined model performed significantly better than the clinical model (p = 0.017, 0.038), but there was no significant difference between the radiomics model and the combined model (p = 0.556, 0.614).
本研究旨在评估各种机器学习模型在识别结肠癌患者淋巴结转移方面的有效性,并探索结合临床放射学和放射组学特征以改善诊断的潜在益处。2015年1月至2024年8月,研究中心1和研究中心2共回顾性纳入了260例经病理证实的结肠癌患者。中心1的198例结肠癌患者按7:3的比例随机分为训练集(n = 138)和内部测试集(n = 60)。中心2的患者被纳入外部测试集(n = 62)。使用五个临床放射学特征建立临床模型。从计算机断层扫描静脉期图像中提取放射组学特征,并使用逻辑回归、支持向量机、决策树和k近邻四个分类器构建机器学习模型。此外,通过结合临床、放射学和放射基因组学特征构建了一个联合模型。在训练集、内部测试集和外部测试集中,根据准确性、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)、受试者工作特征曲线(ROC)和校准曲线对这些模型的性能进行评估,以确定预测效率最高的诊断模型并评估模型的稳定性。在四个机器学习模型中,支持向量机(SVM)模型具有最佳的预测性能,训练集、内部测试集和外部测试集的ROC曲线下面积(AUC)分别为0.813、0.724和0.721。临床模型、放射组学模型和联合模型在训练集、内部测试集和外部测试集中的AUC分别为0.823、0.813、0.817、0.508、0.724、0.751、0.582、0.721和0.744。总之,联合模型的表现明显优于临床模型(p = 0.017,0.038),但放射组学模型与联合模型之间无显著差异(p = 0.556,0.614)。