Li Haojun, Liang Shuoming, Cui Mengxuan, Jin Weiqiu, Jiang Xiaofeng, Lu Simiao, Xiong Jicheng, Chen Hainan, Wang Ziwei, Wang Guotai, Xu Jiming, Li Linfeng, Wang Yao, Qing Haomiao, Han Yongtao, Leng Xuefeng
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
School of Clinical Medicine, Chengdu Medical College, Chengdu, China.
BMC Cancer. 2025 Feb 19;25(1):298. doi: 10.1186/s12885-025-13697-w.
BACKGROUND: Accurate and comprehensive preoperative staging is one of the most important prognostic factors for the management of esophageal cancer (EC). We aimed to develop and validate predictive models using radiomics from preoperative contrast-enhanced Computed Tomography (CT) images to assess pathological staging in EC patients. METHODS: This study retrospectively included 161 patients who underwent esophagectomy at Sichuan Cancer Hospital from July 2018 to February 2023. Pathological staging outcomes encompassed overall TNM staging, T and N staging, and tumor progressions (vascular invasion and perineural invasion). Radiomics features were extracted from segmented regions of tumors. A radiomic signature (Rad-signature) for each outcome was developed using a fivefold cross-validation least absolute shrinkage and selection operator (LASSO) regression model within the training cohort and subsequently validated in the test cohort for predictive accuracy. RESULTS: Out of the 851 radiomics features extracted, two were selected to formulate the Rad-signature for each staging outcome. These signatures showed a significant correlation with their respective outcomes in both the training set and the testing set. Furthermore, the Rad-signature exhibited favorable predictive performance for advanced pTNM staging, advanced pT staging, vascular invasion and perineural invasion, with AUC of 0.721 [95%CI, 0.570-0.872], 0.900 [95%CI 0.805-0.995], 0.824 [0.686-0.961], and 0.737 [0.586-0.887], respectively. However, the predictive performance of the Rad-signature for pN staging is moderate (AUC = 0.693 [0.534-0.852]), indicating needs for additional data modalities. CONCLUSIONS: This study established a non-invasive preoperative radiomics model that demonstrated good predictive performance in determining the pTNM staging, pT staging, vascular invasion, and perineural invasion for EC patients. These results could inform personalized treatment strategies and improve outcomes for EC patients.
背景:准确而全面的术前分期是食管癌(EC)治疗中最重要的预后因素之一。我们旨在开发并验证基于术前增强计算机断层扫描(CT)图像的放射组学预测模型,以评估EC患者的病理分期。 方法:本研究回顾性纳入了2018年7月至2023年2月在四川省肿瘤医院接受食管癌切除术的161例患者。病理分期结果包括总体TNM分期、T和N分期以及肿瘤进展情况(血管侵犯和神经周围侵犯)。从肿瘤的分割区域中提取放射组学特征。使用训练队列中的五折交叉验证最小绝对收缩和选择算子(LASSO)回归模型为每个结果建立放射组学特征(Rad-signature),随后在测试队列中验证其预测准确性。 结果:在提取的851个放射组学特征中,为每个分期结果选择了两个特征来构建Rad-signature。这些特征在训练集和测试集中均与其各自的结果显示出显著相关性。此外,Rad-signature在预测晚期pTNM分期、晚期pT分期、血管侵犯和神经周围侵犯方面表现出良好的预测性能,其曲线下面积(AUC)分别为0.721 [95%置信区间(CI),0.570 - 0.872]、0.900 [95%CI 0.805 - 0.995]、0.824 [0.686 - 0.961]和0.737 [0.586 - 0.887]。然而,Rad-signature对pN分期的预测性能中等(AUC = 0.693 [0.534 - 0.852]),表明需要更多的数据模式。 结论:本研究建立了一种非侵入性术前放射组学模型,该模型在确定EC患者的pTNM分期、pT分期、血管侵犯和神经周围侵犯方面表现出良好的预测性能。这些结果可为个性化治疗策略提供依据,并改善EC患者的治疗效果。
Abdom Radiol (NY). 2025-5