Development of a computed tomography-based radiomics nomogram for prediction of transarterial chemoembolization refractoriness in hepatocellular carcinoma  

作　　者：Xiang-Ke Niu Xiao-Feng He 

机构地区：[1]Department of Interventional Radiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China [2]Department of Interventional Radiology,Affiliated Hospital of Chengdu University,Chengdu 610081,Sichuan Province,China

出　　处：《World Journal of Gastroenterology》2021年第2期189-207,共19页世界胃肠病学杂志（英文版）

基　　金：Health and Family Planning Commission of Sichuan Province,China,No.17PJ430 and No.18PJ150.

摘　　要：BACKGROUND Some patients with hepatocellular carcinoma(HCC)are more likely to experience disease progression despite continuous transarterial chemoembolization(TACE),which is called TACE refractoriness.At present,it is still difficult to predict TACE refractoriness,although some models/scoring systems have been developed.At present,radiological-based radiomics models have been successfully applied to predict cancer patient prognosis.AIM To develop and validate a computed tomography(CT)-based radiomics nomogram for the pre-treatment prediction of TACE refractoriness.METHODS This retrospective study consisted of a training dataset(n=137)and an external validation dataset(n=81)of patients with clinically/pathologically confirmed HCC who underwent repeated TACE from March 2009 to March 2016.Radiomics features were retrospectively extracted from preoperative CT images of the arterial phase.The pre-treatment radiomics signature was generated using least absolute shrinkage and selection operator Cox regression analysis.A CT-based radiomics nomogram incorporating clinical risk factors and the radiomics signature was built and verified by calibration curve and decision curve analyses.The usefulness of the CT-based radiomics nomogram was assessed by Kaplan-Meier curve analysis.We used the concordance index to conduct head-to-head comparisons of the radiomics nomogram with the other four models(Assessment for Retreatment with Transarterial Chemoembolization score;α-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh,and Response score;CT-based radiomics signature;and clinical model).All analyses were conducted according to the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis statement.RESULTS The median duration of follow-up was 61.3 mo(interquartile range,25.5-69.3 mo)for the training cohort and 67.1 mo(interquartile range,32.4-71.3 mo)for the validation cohort.The median number of TACE sessions was 4(range,3-7)in both cohorts.Eight radiomics features were chosen from 869 ca

关 键 词：Hepatocellular carcinoma Transarterial chemoembolization REFRACTORINESS Radiomics NOMOGRAM Computed tomography 

分 类 号：R735.7[医药卫生—肿瘤]