Association Between MRI-Based Radiomics Features and Regional Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma and Its Clinical Outcome

IF 3.3 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Magnetic Resonance Imaging Pub Date : 2024-06-25 DOI:10.1002/jmri.29477

Xianling Qian MD, Xiaoyan Ni MD, Gengyun Miao MM, Fang Wang MS, Changwu Zhou MD, Peng Huang MD, Yunfei Zhang PhD, Lei Chen PhD, Chun Yang PhD, Mengsu Zeng PhD

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引用次数: 0

Abstract

Background

Regional lymph node metastasis (LNM) assessment is crucial for predicting intrahepatic cholangiocarcinoma (iCCA) prognosis. However, imaging assessment has limitations for identifying LNM.

Purpose

To investigate the association between MRI radiomics features, regional LNM status, and prognosis in iCCA.

Study Type

Retrospective.

Subjects

Two hundred ninety-six patients (male = 197) with surgically confirmed iCCA.

Field Strength/Sequence

1.5 T and 3.0 T. DWI, T2WI, and contrast-enhanced T1WI.

Assessment

Clinical information, radiologic, and MRI-based radiomics features associated with LNM status were collected to establish models. Performance of MRI, PET/CT, and the combined LNM models were compared in training (N = 207) and test (N = 89) datasets. Overall survival (OS) was compared based on LNM status.

Statistical Tests

The independent features were selected by 5-fold cross-validation. The performance of MRI, PET/CT, and the models was evaluated using the area under receiver operating characteristic curve (AUC). Univariable and multivariable Cox regression were used to identify independent variables for OS. Kaplan–Meier curves were compared with the log-rank test between LNM positive and negative groups. P < 0.05 was considered statistically significant.

Results

Intrahepatic duct dilatation, enhancement pattern, and CA19-9 were independent clinicoradiologic features. The radiomics model was constructed by the independent radiomics features extracted from T2WI and delay phase T1WI. The combined LNM model showed AUC of 0.888, 0.884, and 0.811 in training, validation, and test cohorts with a positive net benefit. PET/CT exhibited similar sensitivity to the combined LNM model (0.750 vs. 0.733, P > 0.999) while the combined LNM model showed higher specificity (0.703 vs. 0.630, P = 0.039) in the test cohort. High risk of regional LNM was significantly associated with worse OS (median: 24 months) than low risk (median: 30 months, P < 0.0001).

Data Conclusions

The combined LNM model has the strongest correlation with LNM status for mass-forming iCCA patients.

Evidence Level

Technical Efficacy

Stage 2

查看原文本刊更多论文

基于核磁共振成像的放射组学特征与肝内胆管癌区域淋巴结转移及其临床预后的关系

背景：区域淋巴结转移（LNM）评估是预测肝内胆管癌（iCCA）预后的关键。目的：研究 iCCA 的 MRI 放射组学特征、区域淋巴结转移状态和预后之间的关联：研究类型：回顾性：296例经手术确诊的iCCA患者（男性=197例）：1.5T和3.0T。DWI、T2WI和对比增强T1WI：收集与 LNM 状态相关的临床信息、放射学和基于 MRI 的放射组学特征，以建立模型。在训练数据集（N = 207）和测试数据集（N = 89）中比较了 MRI、PET/CT 和 LNM 组合模型的性能。根据LNM状态比较总生存期（OS）：独立特征通过5倍交叉验证选出。使用接收者操作特征曲线下面积（AUC）评估 MRI、PET/CT 和模型的性能。采用单变量和多变量Cox回归确定OS的独立变量。用对数秩检验比较 LNM 阳性组和阴性组的 Kaplan-Meier 曲线。P 结果肝内导管扩张、增强模式和CA19-9是独立的临床放射学特征。从 T2WI 和延迟相 T1WI 中提取的独立放射组学特征构建了放射组学模型。综合 LNM 模型在训练组、验证组和测试组中的 AUC 分别为 0.888、0.884 和 0.811，净获益为正。PET/CT 的灵敏度与 LNM 组合模型相似（0.750 vs. 0.733，P > 0.999），而 LNM 组合模型在测试队列中显示出更高的特异性（0.703 vs. 0.630，P = 0.039）。区域性 LNM 的高风险与较差的 OS（中位数：24 个月）显著相关，而低风险则与较差的 OS（中位数：30 个月）显著相关：30 个月，P 数据结论：综合 LNM 模型与肿块型 iCCA 患者的 LNM 状态相关性最强。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.