基于3D-CT影像组学预测小细胞肺癌经铂类化疗后脑转移的研究

Prediction of Brain Metastasis of Small Cell Lung Cancer After Platinum Chemotherapy Based on 3D-CT Imaging

目的利用3D-CT影像组学预测小细胞肺癌(SCLC)经铂类化疗后脑转移的发生情况。方法回顾性分析采用铂类化疗方案的148例SCLC患者的影像资料,其中发生脑转移者共57例,未发生脑转移者共91例。利用慧影大数据科研平台将数据集按照4∶1随机分成训练集和测试集,提取所勾画病灶上的影像组学特征,利用支持向量机建立影像组学鉴别模型,通过对受试者工作特征曲线下面积、敏感度、特异度及准确率进行分析,预测SCLC在铂类治疗过程中发生脑转移的概率。结果发生脑转移和未发生脑转移组的训练集及测试集的受试者工作特征曲线下面积分别为0.798、0.789,0.798、0.789;训练集未发生脑转移组特异性0.72,准确率为0.80,发生脑转移组中特异性0.71,准确率为0.62,测试集中未发生脑转移组特异性0.83,准确率为0.87,发生脑转移组中特异性0.68,准确率为0.62。结论基于经铂类治疗的SCLC患者肺部CT 3D影像组学特征预测脑转移具有一定临床价值,能对患者进行早期临床干预,从而改善患者预后,提高生存期。

Objective The aim of this paper was to predict the occurrence of brain metastases after platinum chemotherapy for small cell lung cancer(SCLC)using 3D-CT imaging.Methods The imaging data of 148 patients with SCLC who were treated with platinum-based chemotherapy were retrospectively analyzed.Among them,a total of 57 cases developed brain metastasis and 91 cases did not develop brain metastasis.The dataset was randomly divided into training set and test set according to 4:1 using the Huiying Big Data Scientific Research Platform,the imaging characteristics on the delineated lesions were extracted,the imaging identification model was established using a support vector machine,and the probability of brain metastasis in SCLC during platinumbased treatment was predicted by analyzing the area under the curve,sensitivity,specificity,and accuracy of the receiver operating characteristic(ROC).Results The areas under the ROC curves of the training set and the test set in the groups with and without brain metastasis were 0.798,0.789,0.798,and 0.789,respectively;the specificity of the group without brain metastasis in the training set was 0.72,the accuracy rate was 0.80,the specificity of the group with brain metastasis was 0.71,and the accuracy rate was 0.62;the specificity of the group without brain metastasis in the test set was 0.83,the accuracy rate was 0.87,and the specificity of the group with brain metastasis was 0.68,and the accuracy rate was 0.62.Conclusion Prediction of brain metastasis based on 3D ima-ging characteristics of lung CT in SCLC patients treated with platinum has certain clinical value,which can provide early clinical intervention for patients,thereby improving the prognosis of patients and improving survival.