Wang Haoru, Ye Wenhong, Li Ting, Liao Qianyi, Zhang Ya, Liu Longping, He Ling, Chen Xin
Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, 400014, China.
Department of Radiology, Shenzhen Children's Hospital, Shenzhen, 518038, China.
Pediatr Radiol. 2025 May;55(6):1178-1190. doi: 10.1007/s00247-025-06247-w. Epub 2025 May 6.
High-risk neuroblastoma is associated with a poor prognosis, making it crucial to identify patients within this group who face an even higher risk of adverse outcomes.
To determine if integrating clinical indicators and venous-phase enhanced computed tomography radiomics features could improve the prediction of overall survival in high-risk neuroblastoma.
We retrospectively included high-risk neuroblastoma patients treated at a primary institution, randomly stratifying them into a training set (70%) and a test set (30%). Univariate and multivariate Cox regression analyses were used to identify independent clinical risk factors. We then extracted radiomics features from venous-phase enhanced computed tomography images. Clinical risk factors, radiomics score, and combined model were evaluated in the training, test, and external validation sets.
The training, test, and validation sets included 70, 30, and 40 patients, respectively. Neuron-specific enolase was identified as the independent clinical risk factor, with concordance indices of 0.616, 0.627, and 0.595 in the training, test, and validation sets, respectively. The radiomics score achieved concordance indices of 0.699, 0.690, and 0.684 in the training, test, and validation sets, respectively. The combined model showed concordance indices of 0.730, 0.707, and 0.690 in the training, test, and validation sets, respectively. The combined model predicted 5-year overall survival with an area under the receiver operating characteristic curve of 0.780 in the training set, 0.742 in the test set, and 0.710 in the validation set.
Combining neuron-specific enolase and venous-phase enhanced computed tomography radiomics improves survival prediction in high-risk neuroblastoma.
高危神经母细胞瘤预后较差，因此识别该组中面临更高不良结局风险的患者至关重要。
确定整合临床指标和静脉期增强计算机断层扫描影像组学特征是否能改善高危神经母细胞瘤总生存期的预测。
我们回顾性纳入了在一家初级机构接受治疗的高危神经母细胞瘤患者，将他们随机分层为训练集（70%）和测试集（30%）。采用单因素和多因素Cox回归分析来确定独立的临床风险因素。然后我们从静脉期增强计算机断层扫描图像中提取影像组学特征。在训练集、测试集和外部验证集中评估临床风险因素、影像组学评分和联合模型。
训练集、测试集和验证集分别包括70例、30例和40例患者。神经元特异性烯醇化酶被确定为独立的临床风险因素，在训练集、测试集和验证集中的一致性指数分别为0.616、0.627和0.595。影像组学评分在训练集、测试集和验证集中的一致性指数分别为0.699、0.690和0.684。联合模型在训练集、测试集和验证集中的一致性指数分别为0.730、0.707和0.690。联合模型在训练集中预测5年总生存期的受试者工作特征曲线下面积为0.780，在测试集中为0.742，在验证集中为0.710。
将神经元特异性烯醇化酶和静脉期增强计算机断层扫描影像组学相结合可改善高危神经母细胞瘤的生存预测。
