CT影像组学预测结直肠癌肝转移术后患者1年内无进展生存期  

CT radiomics for predicting progression free survival within one year in patients with colorectal cancer liver metastases after surgical resection

作　　者：邢倩 谷小磊 朱海涛 李晓婷[1] 崔湧[1] 孙应实[1] XING Qian;GU Xiaolei;ZHU Haitao;LI Xiaoting;CUI Yong;SUN Yingshi(Department of Radiology,Peking University Cancer Hospital&Institute,Key Laboratory of Carcinogenesis and Translational Research,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国医学影像技术》2022年第7期1035-1040,共6页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(61520106004)。

摘　　要：目的评价CT影像组学模型预测结直肠癌肝转移(CRLM)患者术后1年无进展生存期(PFS)的价值。方法回顾性分析147例CRLM术前末次CT资料,将其分为训练集(n=100)及验证集(n=47),依据临床预后分为预后良好(PFS≥12个月)及预后不佳(PFS<12个月)。手动分割CT所示肝转移灶,提取及选择特征后,基于训练集数据构建影像组学模型,以多因素logistic回归构建临床模型及联合模型。绘制受试者工作特征曲线,计算曲线下面积(AUC),评价并比较各模型预测CRLM患者术后PFS的效能。结果共选出7个特征用于构建影像组学模型。临床模型中,原发灶N分期、有无基因突变及有无术后化疗是预测CRLM患者术后PFS的独立因素;联合模型中的独立因素还包括影像组学评分。影像组学模型、联合模型预测训练集CRLM患者术后PFS的AUC均大于临床模型(0.89、0.93及0.67,P均<0.05);其在验证集的AUC依次为0.77、0.78及0.56,前二者的效能优于临床模型(P<0.05)。结论影像组学模型及联合模型预测CRLM患者1年内PFS的效能均较好。Objective To explore the value of preoperative CT radiomics model for predicting progression free survival(PFS)within one year in patients with colorectal cancer liver metastases(CRLM)after surgical resection.Methods The last time CT data of 147 CRLM patients were retrospectively analyzed.The patients were divided into the training set(n=100)and the validation set(n=47),also into good prognosis group(PFS≥12 months)and poor prognosis group(PFS<12 months)according to clinical prognosis.After manually segmenting the liver lesions,extracting and selecting radiomics features,the radiomics model was constructed based on the training set.Then multivariable logistic regression was used to build the clinical model,radiomics model and combining clinic-radiomics model.The receiver operating characteristic curves were drawn,and the areas under the curves(AUC)were calculated to evaluate the efficacy of the models for predicting PFS within one year in patients with CRLM.Results Seven radiomics features were screened for constructing radiomics model.N stage of primary tumor,the presence of gene mutation and postoperative chemotherapy were all independent predictors for postoperative PFS in patients with CRLM for clinical model,while for combined model,the above indexes and radiomics scores were all independent predictors.AUC of radiomics model and combined model for predicting postoperative PFS in patients with CRLM in training set was higher than that of clinical model(0.89,0.93 and 0.67,both P<0.05),while in validation set was 0.77,0.78 and 0.56,respectively,and the efficacy of combined model was superior to that of clinical model(P<0.05).Conclusion Both radiomics model and combined model had good efficacy for predicting PFS of CRLM patients within one year after surgical resection.

关 键 词：结直肠肿瘤 肝 肿瘤转移 体层摄影术 X线计算机 影像组学 

分 类 号：R735[医药卫生—肿瘤] R814.42[医药卫生—临床医学]