基于多模态MRI影像组学模型预测鼻咽癌放化疗疗效  

Prediction value of multi-modal MRI radiomics model in the efficacy of chemoradiotherapy for nasopharyngeal carcinoma

作　　者：赵灿灿 李淑华 王雪莲 马宜传 徐加利 秦雷 周牧野 谢宗玉 ZHAO Cancan;LI Shuhua;WANG Xuelian;MA Yichuan;XU Jiali;QIN Lei;ZHOU Muye;XIE Zongyu(Department of Radiology,The First Affiliated Hospital of Bengbu Medical University,Bengbu Anhui 233004;Department of Medical Imaging Diagnostics,Bengbu Medical University,Bengbu Anhui 233030,China)

机构地区：[1]蚌埠医科大学第一附属医院放射科,安徽蚌埠233004 [2]蚌埠医科大学医学影像诊断学教研室,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2024年第6期771-775,共5页Journal of Bengbu Medical College

基　　金：蚌埠医学院自然科学研究重点项目(2020byzd128)。

摘　　要：目的:探讨基于多模态MRI影像组学模型在预测鼻咽癌放化疗疗效中的价值。方法:收集经病理证实的151例鼻咽癌病人放化疗前后临床及MRI影像资料。按实体瘤疗效评价标准(RECIST)分为治疗有效组(107例)和治疗无效组(44例),按7∶3的比例随机分为训练集和测试集。首先在治疗前的压脂T2WI、弥散加权成像(DWI)和增强T1WI(CE-T1WI)3个序列上,依次勾划肿瘤原发灶作为ROI,然后提取影像组学特征。经最小最大值归一化预处理及最优特征筛选(个数)降维,选择最佳影像组学特征,分别构建CE-T1WI、T2WI、DWI和3个序列图像联合的逻辑回归模型。通过ROC曲线,评估各模型预测鼻咽癌疗效的效果。对模型的预测性能和受益情况分别采用校准曲线和决策曲线进行评估。结果:联合模型预测效能最佳,其训练组和验证组AUC分别为0.835和0.823,在训练组的特异度、敏感度和准确度分别为80.6%、75.7%、79.0%,验证组对应的数值分别为84.8%、72.7%、78.3%。其中联合模型的预测效能最高,且拟合度较好。决策曲线各模型均能获得较好的临床效益。结论:基于多模态MRI影像组学模型能够有效预测鼻咽癌放化疗疗效,其中联合模型效果最好。Objective:To investigate the prediction value of multi-modal MRI radiomics model in the efficacy of chemoradiotherapy for nasopharyngeal carcinoma.Methods:The clinical and MR imaging data of 151 patients with nasopharyngeal carcinoma confirmed by pathology before and after chemoradiotherapy were collected.The patients were divided into the effective treatment group(107 cases)and ineffective treatment group(44 cases)according to the solid tumor efficacy evaluation criteria(RECIST),and randomly divided into the training set and the test set according to the ratio of 7∶3.First,three sequences of lipid-pressure T2WI,diffusion-weighted imaging(DWI)and enhanced T1WI(CE-T1WI)before treatment were mapped successively as ROI,and then the image omics features were extracted.After the minimum-maximum normalization preprocessing and optimal feature screening(number)dimensionality reduction,the best image omics features were selected to construct the logistic regression model of CE-T1WI,T2WI,DWI and three sequential images.The ROC curve was used to evaluate the effects of each model predicting the efficacy of nasopharyngeal cancer.The predictive performance and benefit of the model were evaluated by calibration curve and decision curve,respectively.Results:The predictive performance of joint model was the best,the AUC of the training and test groups were 0.835 and 0.823,respectively.The specificity,sensitivity,and accuracy in the training group were 80.6%,75.7%,and 79.0%,respectively,while the specificity,sensitivity,and accuracy in the test group were 84.8%,72.7%,and 78.3%,respectively.The joint model had the highest predictive performance and good fit.All models of decision curve could achieve good clinical benefits.Conclusions:Multi-modal MRI radiomics model can effectively predict the efficacy of chemoradiotherapy for nasopharyngeal carcinoma,and the effect of joint model is the best.

关 键 词：鼻咽肿瘤 磁共振成像 影像组学 

分 类 号：R739.6[医药卫生—肿瘤]