基于18F-FDG PET/CT图像的影像组学列线图对胃癌术后的预后评估  

Predicative value of radiomics nomogram based on 18F-FDG PET/CT for the prognosis of patients with postoperative gastric carcinoma

作　　者：袁清玉 江玉明[2] 吕闻冰 吴湖炳[1] 王全师[1] Yuan Qingyu;Jiang Yuming;Lyu Wenbing;Wu Hubing;Wang Quanshi(Department of PET Center,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of General Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;School of Biomedical Engineering,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院PET中心,广州510515 [2]南方医科大学南方医院普外科,广州510515 [3]南方医科大学生物医学工程学院,广州510515

出　　处：《中华核医学与分子影像杂志》2019年第1期2-5,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨基于18F-脱氧葡萄糖(FDG)PET/CT的影像组学特征集联合临床病理危险因素建立的影像组学列线图对胃癌术后预后的评估价值。方法回顾性分析2008年1月至2015年8月间207例胃癌患者(男143例,女64例,年龄20~85岁)的PET/CT显像结果,分为训练组(104例)和验证组(103例);记录患者临床病理资料和无病生存(DFS)期,筛选出PET/CT图像中有意义的纹理特征,计算影像组学评分(RS)并探索其与DFS的关系;行Cox回归得到术后胃癌DFS的危险因素;构建影像组学列线图并评价其对胃癌术后复发、转移的预测效能,计算一致性指数(C指数)。结果多因素Cox回归显示,RS、肿瘤部位、肿瘤浸润深度、淋巴结转移和远处转移是胃癌患者DFS相关的危险因素(风险比:2.148~2.828,均P<0.05)。综合上述5个危险因素得到的影像组学列线图比单独RS能更准确地预测DFS:训练组两者C指数分别为0.830和0.700,验证组对应值分别0.776和0.681。结论结合影像组学特征集与临床病理危险因素建立的影像组学列线图可更准确地预测胃癌患者生存情况。Objective To investigate the clinical value of radiomics nomogram,which is established by 18F-fluorodeoxyglucose(FDG)PET/CT radiomics signature combined with clinical-pathologic risk factors,in predicting the prognosis of patients with postoperative gastric carcinoma.Methods 18F-FDG PET/CT data of 207 patients(143 males,64 females,age range:20-85 years)with postoperative gastric carcinoma from January 2008 to August 2015 was reviewed retrospectively.Patients were divided into training group(n=104)and validation group(n=103),and the clinicopathologic information and disease-free survival(DFS)data were acquired.Significant textural features were selected from PET/CT images,and radiomics score(RS)for individual patient was calculated based on the radiomics signatures.The relationship between RS and DFS was analyzed.Cox regression analysis was performed to determine the risk factors of DFS.The radiomics nomogram,obtained from combination of RS with clinicopathologic risk factors,was established and further evaluated in predictive value for recurrence or metastasis of postoperative gastric carcinoma,and the concordance index(C-index)was calculated.Results Cox regression analysis demonstrated that RS,tumor location,depth of invasion,lymph node metastasis,and distant metastasis were the significant risk factors for DFS(hazard ratios:2.148-2.828,all P<0.05).The radiomics nomogram combined with RS and 4 clinicopathologic risk factors had a better prediction for the estimated DFS,comparing to RS alone.C-index of radiomics nomogram and RS were 0.830 and 0.700 in training group,and 0.776 and 0.681 in validation group,respectively.Conclusion Radiomics nomogram which is established by radiomics signatures and clinicopathologic risk factors may be better for predicting DFS of patients with postoperative gastric carcinoma.

关 键 词：胃肿瘤 预后 正电子发射断层显像术 体层摄影术 X线计算机 列线图 脱氧葡萄糖 

分 类 号：R735.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]