基于CT影像组学模型术前预测喉癌淋巴结转移  

Preoperative prediction of lymph node metastasis of laryngeal carcinoma based on CT radiomics model

作　　者：郭峰[1,2] 罗琦 郑伊能[1] 曾春 李咏梅[1] GUO Feng;LUO Qi;ZHENG Yi-neng(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]重庆市九龙坡区中医院放射科,重庆400080

出　　处：《放射学实践》2021年第11期1365-1370,共6页Radiologic Practice

摘　　要：目的:研究CT影像组学在术前预测喉癌患者淋巴结转移中的价值。方法:搜集本院304例经手术病理证实为喉癌患者的影像学资料,随机选择243例及61例分别作为训练集和验证集。从术前静脉期CT图像中手工勾画肿瘤体积并提取影像组学特征。在训练集中,采用LASSO回归进行特征筛选,使用Logistic回归分别构建影像组学模型、形态学模型及二者联合模型。利用受试者工作特征(ROC)曲线评价各个模型的预测效能,并对模型的ROC曲线行Delong检验。在验证集中评估各种模型的诊断效能。结果:最后获得5个影像组学特征。在训练集中,影像组学模型ROC曲线下面积(AUC)为0.85(95%CI:0.77~0.93),形态学模型AUC为0.66(95%CI:0.59~0.72),联合模型AUC为0.82(95%CI:0.74~0.91);在验证集中,影像组学模型AUC为0.83(95%CI:0.69~0.97),形态学模型AUC为0.59(95%CI:0.40~0.77),联合模型AUC为0.73(95%CI:0.56~0.91)。Delong检验显示影像组学模型与形态学模型差异、联合模型与形态学模型差异均有统计学意义(P<0.05),而联合模型与影像组模型差异无统计学意义(P>0.05)。结论:基于病灶为兴趣区的CT影像组学模型可以术前较好地预测喉癌淋巴结转移,其诊断效能高于形态学模型。Objective:To explore the value of CT radiomics model in predicting lymph node metastasis of laryngeal carcinoma before operation.Methods:The imaging data of 304 patients with laryngeal carcinoma confirmed by surgical pathology examination were collected.243 cases and 61 cases were randomly selected as a training set and a verification set,respectively.The volume of tumor was manually drawn on the venous phase CT images and radiomics features were extracted.In the training set,LASSO regression was used to screen the radiomics features,and logistic regression analysis was performed to construct the radiomics model,morphological model and their combined model.The diagnostic efficiencies of different models were evaluated using ROC curve analysis and compared using the Delong's test.Finally,the diagnostic efficiencies of different models in the validation set was evaluated.Results:Five radiomics features were extracted.In the training set,the AUC of the radiomics model was 0.85(95%CI:0.77~0.93),the AUC of the morphological model was 0.66(95%CI:0.59~0.72),the AUC of the combined model was 0.82(95%CI:0.74~0.91);In the validation set,the AUC of the radiomics model was 0.83(95%CI:0.69~0.97),the AUC of the morphological model was 0.59(95%CI:0.40~0.77),and the AUC of the combined model was 0.73(95%CI:0.56~0.91).Delong's test showed that there were statistically significant differences between the combined model and the morphological model as well as the radiomics model and the morphological model(P<0.05),but there was no significant difference between the combined model and the radiomics model(P>0.05).Conclusion:CT radiomics model based on lesions as region-of-interest can predict the lymph node metastasis of laryngeal carcinoma before operation,and its diagnostic efficiency is higher than the morphological model.

关 键 词：喉肿瘤 影像组学 体层摄影术 X线计算机 淋巴结转移 

分 类 号：R814.42[医药卫生—影像医学与核医学] R739.65[医药卫生—放射医学]