超声影像组学标签预测乳腺癌前哨淋巴结转移的价值  

Ultrasound-based radiomics to predict sentinel lymph node metastasis in breast cancer

作　　者：暴珞宁 王瑛[3] 陈东[4] 刘再毅 BAO Luoning;WANG Ying;CHEN Dong;LIU Zaiyi(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,China;Department of Radiology,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China;不详)

机构地区：[1]南方医科大学第二临床医学院,广州510515 [2]广东省人民医院(广东省医学科学院)放射科,广州510080 [3]广州医科大学附属第一医院超声科,广州510120 [4]昆明医科大学第三附属医院(云南省肿瘤医院)超声科,昆明650118

出　　处：《实用医学杂志》2021年第15期2007-2011,共5页The Journal of Practical Medicine

基　　金：国家重点研发计划项目(编号:2017YFC1309100)。

摘　　要：目的探讨基于常规超声的影像组学标签在术前诊断乳腺癌前哨淋巴结转移的应用价值。方法收集2020年1-10月194例经我院诊治的乳腺癌患者的临床资料和术前超声图像,按超声检查时间顺序,将患者分为训练集(n=103)和验证集(n=88)。通过Image J软件手动勾画病灶区域,使用Pyradiomics从每个病灶区域中提取1130个特征,采用多种方法逐步筛选特征,利用逻辑回归模型构建超声影像组学标签。采用受试者工作特征(ROC)曲线、校准曲线和决策曲线等评估超声影像组学标签预测乳腺癌前哨淋巴结转移的效能。结果筛选出6个关键超声影像组学特征用于构建超声影像组学标签。该标签在训练集和验证集中预测乳腺癌前哨淋巴结转移的ROC曲线下面积分别为0.795(95%CI:0.708~0.882)、0.784(95%CI:0.688~0.881)。在校准曲线中,该标签在训练集和验证集里表现出好的校准度(P=0.985、0.854),决策曲线分析进一步表明了该标签对临床决策有辅助作用。结论基于常规超声的影像组学标签可用于术前预测乳腺癌有无前哨淋巴结转移,为临床制定个体化的手术方式提供更多参考依据。Objective To explore the value of a radiomics model based on ultrasound imaging in predicting the sentinel lymph node status of breast cancer before surgery.Methods A total of 194 patients with earlystage breast cancer were retrospectively analyzed,all patients underwent preoperative breast ultrasound examination.According to the order of examination time,the patients were divided into training group(n=103)and validation group(n=88).Image J software was used to manually delineate the lesion area in the ultrasound image along the tumor boundary.Pyradiomics was used to extract 1130 features from each lesion area,and the features were screened using three statistical methods.Finally,an ultrasound imaging radiomics model was built using a logistic regression model.To evaluate the performance and value of an ultrasound imaging radiomics model in predicting sentinel lymph node status,the receive operating characteristic curve(ROC),calibration curve,and decision curve were used.Results To construct the ultrasound imaging radiomics model,6 key image features were chosen.The area of under the ROC curve of the model in the training group and the validation group were 0.795(95%CI:0.708-0.882)and 0.784(95%CI:0.688-0.881),respectively.The calibration curve showed that the model had a good calibration in both the training and validation groups;Additionally,the decision curve analysis confirmed that the model could support clinical decision-making.Conclusion Ultrasound-based imaging radiomics model is of great value in predicting the sentinel lymph node status of breast cancer before surgery.

关 键 词：超声图像 影像组学 乳腺癌 前哨淋巴结 预测模型 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]