基于瘤周CT影像组学评估肺恶性肿瘤微波消融的早期疗效

Based on Peritumoral CT Radiomics May Assess the Early Efficacy of Microwave Ablation in Lung Malignant Tumors

目的探讨基于瘤周CT图像的影像组学模型在评估肺恶性肿瘤微波消融(MWA)早期疗效的价值。方法分析经病理证实为肺恶性肿瘤并行MWA治疗的95例患者,按照7∶3的比例将患者随机分为训练集和验证集。依据改良实体肿瘤疗效评价标准(mRECIST),以MWA后6~10周时的病灶作为基线,通过CT随访的影像学变化来判断疗效,将患者分类为治疗有效组(76例)和无效组(19例)。在MWA即刻CT图像上逐层勾画肿瘤周围磨玻璃影(GGO)为感兴趣区(ROI),提取影像组学特征并进行降维,得出有统计学差异的参数。在训练集中采用Logistic回归构建MWA疗效评估的模型。将受试者工作特征曲线(ROC)曲线下面积(AUC)、准确率、敏感度、特异度、校准曲线用于模型性能评估。结果共提取396个特征值,最终筛选出4个特征用来建立模型。在训练集中,该模型的AUC值为0.766(95%CI:0.576~0.957),准确率为86.4%,敏感度为92.5%,特异度为61.5%。在验证集中,该模型AUC值为0.775(95%CI:0.573~0.978),准确率为79.3%,敏感度为78.3%,特异度为83.3%。该模型的校准曲线显示较好的校准度。结论基于瘤周CT构建的影像组学模型对肺恶性肿瘤MWA早期疗效的评估有一定的价值。

Objective To investigate value of radiomic model based on peritumoral CT images in assessing the early efficacy of microwave ablation(MWA)for lung malignant tumors.Methods 95 patients with pathologically confirmed lung malignancy who were treated with MWA were randomly divided into training group and validation group in a ratio of 7∶3.According to mRECIST criteria,the lesions 6-10 weeks after MWA were taken as the baseline,and the efficacy was determined by CT follow-up imaging changes.The patients were classified into the effective group(76 cases)and the ineffective group(19 cases).The ground-glass opacity(GGO)around the tumor was delineated layer by layer on the MWA immediate CT image as the region of interest(ROI),and the radiomics features were extracted and dimensionally reduced to obtain parameters with statistical differences.Logistic regression was used to construct the model of MWA efficacy in the training group.The area under curve(AUC),accuracy,sensitivity,specificity and calibration curve were used to evaluate the performance of the model.Results A total of 396 features were extracted,and 4 features were selected to establish the model.In the training group,the AUC value of the model was 0.766(95%CI:0.576-0.957),the accuracy was 86.4%,the sensitivity was 92.5%,and the specificity was 61.5%.In the validation group,the AUC value of the model was 0.775(95%CI:0.573-0.978),the accuracy was 79.3%,the sensitivity was 78.3%,and the specificity was 83.3%.The calibration curve of the model showed good calibration degree.Conclusion The radiomics model based on peritumoral CT has certain value in assessing the early efficacy of MWA in lung malignant tumors.