诊断学理论与实践2024，Vol.23Issue(1)：46-56,11.DOI:10.16150/j.1671-2870.2024.01.007
基于T2WI和DWI的磁共振影像组学在术前预测直肠癌壁外血管侵犯的价值研究
The value of radiomics based on T2WI and DWI of MRI in preoperative prediction of extramural vascular inva-sion in rectal cancer
摘要
Abstract
Objective To investigate the diagnostic performance of radiomics based on T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)of MRI for preoperative prediction of extramural vascular invasion(EMVI)in rectal cancer.Methods A total of 168 patients with pathology-confirmed rectal adenocarcinoma were enrolled during January 2010 to June 2023.The patients underwent preoperative rectal MRI scans,and they were randomly divided into training set and validation set at a 7∶3 ratio.Radiomic features from T2WI and DWI were extracted and selected by dimensionality re-duction using the maximum relevance minimum redundancy(mRMR)method and the least absolute shrinkage and selec-tion operator(LASSO)regression analysis with ten-fold cross-validation.The radiomic total score(Radscore)for each pa-tient was calculated to make radiomics model.The training set enrolled three clinical features[gender,age and preoperative level of carcinoembryonic antigen(CEA)]and six magnetic resonance imaging features[ADC value,depth of infiltration,tu-mor length,tumor location,T staging and magnetic resonance imaging-defined extramural vascular invasion(mrEMVI)].The clinical model was established through univariable and multivariable logistic regression analysis based on above clinical and imaging features,and the clinical-radiomics model(combined model)was established with Radscore and independent risk factors from the clinical model.The diagnostic efficacy of each model was assessed using receiver operating characteris-tic(ROC)curve.The differences in performance among the models were compared using the DeLong test.The Calibration curves were employed to evaluate the consistence between the preoperative predictive results obtained from the nomogram and the postoperative pathological results.Additionally,decision curve analysis(DCA)was applied to evaluate the clinical utility of the three models.Results The area under the curve(AUC)of the ROC curve for the combined model,clinical model,and radiomics model in the training were 0.926,0.888,0.756,and were 0.917,0.896,0.782 in validation sets,re-spectively.The DeLong test showed that the diagnostic efficacy of combined model was higher than that of radiomics model in both training and validation sets(P<0.05).The diagnostic efficacy of combined model was better than that of clinical model in the training set(P<0.05).The calibration curve showed the consistency between the preoperative predictive re-sults obtained from the nomogram and the postoperative pathological findings was satisfied.The DCA showed that the risk threshold probabilities between 0.24 and 0.77,the clinical benefit of combined model was higher than those of clinical model and the radiomics model.Conclusions For preoperative prediction of EMVI in rectal cancer,the radiomics model based on T2WI and DWI of MRI has a satisfied diagnostic efficiency,while the clinical-radiomics model(combined model)may further enhance the diagnostic efficiency.关键词
直肠癌/壁外血管侵犯/磁共振成像/影像组学/预测模型/列线图Key words
Rectal cancer/Extramural vascular invasion/Magnetic resonance imaging/Radiomics/Prediction model/Nomogram分类
医药卫生引用本文复制引用
丁景峰,敖炜群,朱珍,孙静,徐良根,郑世保,俞晶晶,胡金文..基于T2WI和DWI的磁共振影像组学在术前预测直肠癌壁外血管侵犯的价值研究[J].诊断学理论与实践,2024,23(1):46-56,11.基金项目
浙江省卫生健康委员会面上项目(2022KY122) （2022KY122）
