基于增强CT影像组学模型和临床特征模型评估进展期胃癌浆膜侵犯

Development and validation of models to predict serosal invasion in advanced gastric cancer using the enhanced CT imaging-based radiomics features and clinical features

目的:探讨基于增强CT影像组学模型和临床特征模型评估进展期胃癌浆膜侵犯的价值。方法:收集351例术前2周内行腹部增强CT检查进展期胃癌患者资料并以7:3比例随机分为训练组247例和验证组104例。基于动静脉期CT图像在A.K软件中共提取3190个影像组学特征,通过降维筛选后建立影像组学模型,比较进展期胃癌浆膜侵犯阳性和阴性组之间的临床特征差异,并构建临床模型。模型效能评估采用受试者工作特征曲线分析。结果:在训练组和验证组中,N、M分期在浆膜侵犯阳性组和阴性组间的差异有统计意义(P<0.05)。基于动静脉期图像最终筛选出14个影像组学特征。在验证组中,影像组学模型预测进展期胃癌浆膜侵犯的诊断效能高于基于联合N分期和M分期构建临床模型的诊断效能(AUC:0.854 vs 0.793)。结论:基于增强CT影像组模型和基于N、M分期的临床模型均能够成功预测进展期胃癌浆膜侵犯,前者诊断效能较优。

Objective To explore the predictive value of the enhanced CT imaging-based radiomics model and the clinical model for the serosal invasion in advanced gastric cancer.Methods The data were collected from 351 patients with advanced gastric cancer who underwent abdominal enhanced CT examination within 2 weeks before surgery,and the patients were randomly divided into a training group(n=247)and a validation group(n=104)in a ratio of 7:3.The 3190 radiomics features which were extracted from the arterial and venous phase CT images using A.K software were dimensionally reduced for constructing a radiomics model.The pathological features between serosal invasion positive and negative groups were compared,and the significant features were used to establish a clinical model.The model's performance was evaluated using receiver operating characteristic curve.Results In the training and validation groups,N staging and M staging were different in serosal invasion positive and negative groups(P<0.05).A total of 14 radiomic features were ultimately selected from the arterial and venous phase images.In the validation group,the diagnostic efficacy of the radiomic model for predicting serosal invasion in advanced gastric cancer was higher than that of the clinical model based on the combination of N staging and M staging(AUC:0.854 vs 0.793).Conclusion Both the radiomics model based on the enhanced CT imaging and the clinical model based on the combination of N staging and M staging can successfully predict serosal invasion in advanced gastric cancer,but the former performs better.