基于多参数MRI影像组学的列线图预测肾透明细胞癌同时远处转移的研究  

Multiparametric MRI-based Radiomics Nomogram for Prediction of Synchronous Distant Metastasis in Clear Cell renal Cell Carcinoma

作　　者：简远熙 柳瑞[1] 谭欣 陈梦林 赵倩 吴俊霖 陈渊 杨素萍 JIAN Yuanxi;LIU Rui;TAN Xin(Department of Radiology,The Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650101,P.R China)

机构地区：[1]昆明医科大学第二附属医院放射科,云南650101

出　　处：《临床放射学杂志》2025年第5期907-913,共7页Journal of Clinical Radiology

基　　金：云南省教育厅科学研究基金项目(编号:2024J0235)。

摘　　要：目的探讨基于多参数MRI影像组学的列线图预测肾透明细胞癌同时远处转移的价值。方法回顾性搜集135例经病理证实的肾透明细胞癌患者的首次MRI及临床资料;其中发生同时远处转移48例,未发生同时远处转移87例;按照7∶3比例随机将其分为训练集(n=95)和测试集(n=40)。采用3D-Slicer软件逐层勾画病灶的感兴趣区,并提取影像组学特征。依次采用t检验、相关性分析和最小绝对收缩和选择法筛选最优特征,构建MRI影像组学模型,并计算放射组学标签得分。评估临床特点和MRI表现建立临床模型,并结合放射组学评分和临床特征构建联合模型,最终构建列线图。应用受试者工作特征曲线(ROC)曲线下面积(AUC)、敏感度、特异度和准确率评估模型的预测效能。结果影像组学模型、临床模型及联合模型在测试集的AUC分别为0.883(0.773~0.925)、0.746(0.591~0.783)及0.917(0.830~0.954)。决策曲线分析显示,联合模型构建的列线图的临床实用性优于临床模型和影像组学模型。结论基于多参数MRI影像组学的列线图结合放射组学标签得分和临床特征,可在术前无创鉴别肾透明细胞癌是否发生同时远处转移。Objective To investigate the value of predicting synchronous distant metastasis in clear cell renal cell carcinoma(ccRCC)based on multiparametric MRI radiomics.Methods Retrospective collection of first MRI and clinical data of 135 patients with pathologically confirmed clear cell renal cell carcinoma.Of these,48 cases developed synchronous distant metastasis and 87 cases did not.The patients were randomly divided into a training set(n=95)and a test set(n=40)according to a 7∶3 ratio.The 3D-Slicer software was used to outline the region of interest(ROI)of the lesion layer by layer and to extract radiomics features.t-test,correlation analysis,and least absolute shrinkage and selection operator(LASSO)were used sequentially to screen the optimal features,construct the MRI radiomics model,and calculate the radiomics signature scores.Clinical models were established based on clinical features and MRI findings,and a combined model was constructed by integrating radiomics scores and clinical features,ultimately forming a nomogram.The predictive efficacy of the models was assessed using the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and accuracy.Results The AUCs of the radiomics model,clinical model,and combined model in the test set were 0.883(95%CI:0.773-0.925),0.746(95%CI:0.591-0.783),and 0.917(95%CI:0.830-0.954),respectively.Decision curve analysis showed that the nomogram constructed by the combined model had superior clinical utility compared to the clinical model and radiomics model alone.Conclusion Based on multiparametric MRI radiomics combined with radiomics signature scores and clinical features,it is possible to non-invasively identify preoperatively whether clear cell renal cell carcinoma develops synchronous distant metastasis.

关 键 词：肾透明细胞癌多参数 磁共振成像 影像组学 列线图 

分 类 号：R737.11[医药卫生—肿瘤]