Gong Jie, Meng Fan, Liu Changhao, Lu Jianchao, Li Jie, Yang Zhi, Sun Hongfei, Teng Xinzhi, Zhang Jiang, Cai Jing, Shi Mei, Zhao Lina
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Insights Imaging. 2025 Aug 2;16(1):166. doi: 10.1186/s13244-025-02044-z.
To investigate whether radiomic features (RFs) repeatability and their prognostic value are study-specific.
This retrospective study included 234 esophageal cancer (EC) patients (contrast-enhanced computed tomography (CECT) and fluorine-18 fluorodeoxyglucose positron emission tomography (PET)), and 525 nasopharyngeal carcinoma (NPC) patients (CECT). Tumor, peritumor, and lymph node regions were defined as regions of interest. RF repeatability was assessed via perturbation analysis using intraclass correlation coefficients (ICC), with consistency and differences across cancer types, pathological regions, and modalities evaluated. The independent prognostic features common to both EC and NPC were screened from highly repeatable features using C-index and redundancy analysis.
CT-based RFs in NPC and PET-based RFs in EC demonstrated significantly higher repeatability compared to CT-based RFs in EC (median ICC: 0.886 vs 0.806; 0.897 vs 0.806; p < 0.05). While CT-based peritumoral features showed comparable repeatability to tumor features in EC (0.824 vs 0.806, p > 0.05), PET-based peritumoral features exhibited significantly lower repeatability than tumor features (0.819 vs 0.897, p < 0.05). CT-based lymph node features demonstrated significantly lower repeatability than tumor features in NPC (0.863 vs 0.886, p < 0.05). Nevertheless, the effects of bin count, feature class, and filter on repeatability demonstrated consistent patterns across different cancer types, imaging modalities, and pathological regions. Moreover, four common independent prognostic features effectively stratified both EC and NPC patients into high- and low-risk groups with significant survival differences (p < 0.05).
RF repeatability might be affected by cancer type, pathological region, and imaging modality, while certain features maintain consistent prognostic performance across different cancer types.
The identification of high-repeatable pan-cancer prognostic radiomics features enables noninvasive patient risk stratification to guide personalized therapy, with cross-cancer consistency enhancing their applicability and convenience in clinical practice, thereby accelerating the integration of radiomics into precision oncology clinical workflows.
This study examined RF repeatability and prognostic value specificity. RF repeatability varies across cancer types, regions, and modalities. The common highly repeatable RFs advance pan-cancer biomarker precision oncology.
研究放射组学特征（RFs）的可重复性及其预后价值是否具有研究特异性。
这项回顾性研究纳入了234例食管癌（EC）患者（对比增强计算机断层扫描（CECT）和氟-18氟脱氧葡萄糖正电子发射断层扫描（PET））以及525例鼻咽癌（NPC）患者（CECT）。将肿瘤、瘤周和淋巴结区域定义为感兴趣区域。通过使用组内相关系数（ICC）的扰动分析评估RF的可重复性，并评估不同癌症类型、病理区域和成像方式之间的一致性和差异。使用C指数和冗余分析从高度可重复的特征中筛选出EC和NPC共有的独立预后特征。
与EC中基于CT的RFs相比，NPC中基于CT的RFs和EC中基于PET的RFs显示出显著更高的可重复性（中位ICC：0.886对0.806；0.897对0.806；p < 0.05）。虽然在EC中基于CT的瘤周特征与肿瘤特征显示出相当的可重复性（0.824对0.806，p > 0.05），但基于PET的瘤周特征显示出比肿瘤特征显著更低的可重复性（0.819对0.897，p < 0.05）。在NPC中，基于CT的淋巴结特征显示出比肿瘤特征显著更低的可重复性（0.863对0.886，p < 0.05）。然而，箱数、特征类别和滤波器对可重复性的影响在不同癌症类型、成像方式和病理区域中呈现出一致的模式。此外，四个共同的独立预后特征有效地将EC和NPC患者分为高风险和低风险组，生存差异显著（p < 0.05）。
RF的可重复性可能受癌症类型、病理区域和成像方式的影响，而某些特征在不同癌症类型中保持一致的预后性能。
识别高可重复的泛癌预后放射组学特征能够实现无创的患者风险分层，以指导个性化治疗，跨癌症的一致性增强了它们在临床实践中的适用性和便利性，从而加速放射组学融入精准肿瘤学临床工作流程。
本研究考察了RF的可重复性和预后价值特异性。RF的可重复性因癌症类型、区域和成像方式而异。常见的高度可重复RFs推动了泛癌生物标志物精准肿瘤学的发展。
