基于动态对比增强磁共振成像的影像组学分析预测肝细胞癌患者肝切除术后早期复发

Radiomics analysis based on dynamic contrast-enhanced MRI for predicting early recurrence after hepatectomy in hepatocellular carcinoma patients.

作者信息

Wang Kai-Di, Guan Ming-Jing, Bao Zi-Yang, Shi Zhe-Jin, Tong Hai-Hang, Xiao Zun-Qiang, Liang Lei, Liu Jun-Wei, Shen Guo-Liang

机构信息

General Surgery, Cancer Center, Department of Hepatobiliary and Pancreatic Surgery and Minimal Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, China.

Department of the Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.

出版信息

Sci Rep. 2025 Jul 1;15(1):22240. doi: 10.1038/s41598-025-02291-6.

Abstract

This study aimed to develop a machine learning model based on Magnetic Resonance Imaging (MRI) radiomics for predicting early recurrence after curative surgery in patients with hepatocellular carcinoma (HCC).A retrospective analysis was conducted on 200 patients with HCC who underwent curative hepatectomy. Patients were randomly allocated to training (n = 140) and validation (n = 60) cohorts. Preoperative arterial, portal venous, and delayed phase images were acquired. Tumor regions of interest (ROIs) were manually delineated, with an additional ROI obtained by expanding the tumor boundary by 5 mm. Radiomic features were extracted and selected using the Least Absolute Shrinkage and Selection Operator (LASSO). Multiple machine learning algorithms were employed to develop predictive models. Model performance was evaluated using receiver operating characteristic (ROC) curves, decision curve analysis, and calibration curves. The 20 most discriminative radiomic features were integrated with tumor size and satellite nodules for model development. In the validation cohort, the clinical-peritumoral radiomics model demonstrated superior predictive accuracy (AUC = 0.85, 95% CI: 0.74-0.95) compared to the clinical-intratumoral radiomics model (AUC = 0.82, 95% CI: 0.68-0.93) and the radiomics-only model (AUC = 0.82, 95% CI: 0.69-0.93). Furthermore, calibration curves and decision curve analyses indicated superior calibration ability and clinical benefit. The MRI-based peritumoral radiomics model demonstrates significant potential for predicting early recurrence of HCC.

摘要

本研究旨在开发一种基于磁共振成像(MRI)影像组学的机器学习模型,用于预测肝细胞癌(HCC)患者根治性手术后的早期复发。对200例行根治性肝切除术的HCC患者进行了回顾性分析。患者被随机分配到训练队列(n = 140)和验证队列(n = 60)。采集术前动脉期、门静脉期和延迟期图像。手动勾勒肿瘤感兴趣区域(ROI),并通过将肿瘤边界扩大5 mm获得额外的ROI。使用最小绝对收缩和选择算子(LASSO)提取并选择影像组学特征。采用多种机器学习算法开发预测模型。使用受试者工作特征(ROC)曲线、决策曲线分析和校准曲线评估模型性能。将20个最具鉴别力的影像组学特征与肿瘤大小和卫星结节整合用于模型开发。在验证队列中,与临床瘤内影像组学模型(AUC = 0.82,95% CI:0.68 - 0.93)和仅影像组学模型(AUC = 0.82,95% CI:0.69 - 0.93)相比,临床瘤周影像组学模型显示出更高的预测准确性(AUC = 0.85,95% CI:0.74 - 0.95)。此外,校准曲线和决策曲线分析表明其具有更好的校准能力和临床效益。基于MRI的瘤周影像组学模型在预测HCC早期复发方面显示出巨大潜力。

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