Clinical Study of Post-Chemotherapy Cardiotoxicity in Breast Cancer Patients Based on Ultrasound Radiomics

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-03-29 DOI:10.1111/echo.70136

Caiyun Xia, Shutian Wu, Yuxin Zhong, Jiangtao Wang, Alin Yao, Biaohu Liu

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引用次数: 0

Abstract

Purpose

The aim of this study is to develop and validate a combined model based on ultrasound radiomics to detect cardiotoxicity after chemotherapy in patients with breast cancer.

Methods

In this paper, we included 208 patients with breast cancer diagnosed pathologically and after chemotherapy, of whom had high-quality echocardiographic images; among them, 105 cases experienced cardiotoxicity, while 103 cases did not, which were divided into a training set and a validation set using a wholly randomized method according to a ratio of 7:3. Then, the left ventricular myocardium in the parasternal long-axis view of echocardiography was manually traced, the myocardial features of each image were extracted and filtered, and then a radiomics model was established; lastly, we plotted the receiver operating characteristic (ROC) curve; calculated the area under the curve (AUC); and assessed the diagnostic performance of the model.

Results

The AUC of the combined model in the training set was 0.88 (95%CI,0.828–0.936), which was higher than the clinical model at 0.73 (95%CI,0.646–0.807) and the radiomics model at 0.84 (95%CI,0.774–0.903). In the validation set, the AUC of the combined model was 0.87 (95%CI,0.783–0.959), which was higher than the clinical model at 0.75 (95%CI,0.631–0.877) and the radiomics model at 0.81 (95%CI,0.698–0.917). The combined model of the training group and the validation group had statistical significance compared to both the clinical model and the radiomics model (Z = −4.066, p < 0.001; Z = −1.977, p = 0.048); (Z = −1.986, p = 0.047; Z = −2.142, p = 0.032). Meanwhile, the results of Hosmer–Lemeshow goodness-of-fit test were favorable (the training group: X² = 6.776, p = 0.561; the validation group: X² = 11.949, p = 0.154).

Conclusion

The combined model based on radiomics is an effective tool for the early diagnosis of cardiac toxicity in breast cancer patients after chemotherapy. It helps to detect cardiotoxicity of breast cancer patients during chemotherapy.

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基于超声放射组学的乳腺癌患者化疗后心脏毒性临床研究

目的建立并验证一种基于超声放射组学的联合模型来检测乳腺癌患者化疗后的心脏毒性。方法选取208例经病理诊断及化疗后的乳腺癌患者，其中超声心动图高质量；其中105例发生心脏毒性，103例未发生心脏毒性，采用完全随机的方法按7:3的比例分为训练集和验证集。然后，对超声心动图胸骨旁长轴视图下的左心室心肌进行人工跟踪，对每张图像的心肌特征进行提取和滤波，建立放射组学模型；最后绘制受试者工作特征（ROC）曲线；计算曲线下面积（AUC）；并对模型的诊断性能进行了评估。结果联合模型在训练集中的AUC为0.88 (95%CI,0.828 ~ 0.936)，高于临床模型的0.73 （95%CI,0.646 ~ 0.807）和放射组学模型的0.84 （95%CI,0.774 ~ 0.903）。在验证集中，联合模型的AUC为0.87 (95%CI, 0.783-0.959)，高于临床模型的0.75 （95%CI, 0.631-0.877）和放射组学模型的0.81 （95%CI, 0.698-0.917）。训练组与验证组联合模型与临床模型、放射组学模型比较，差异均有统计学意义(Z = - 4.066, p <；0.001;Z =−1.977,p = 0.048)；(Z =−1.986,p = 0.047；Z =−2.142,p = 0.032)。同时，Hosmer-Lemeshow拟合优度检验结果较好(训练组：X2 = 6.776, p = 0.561；验证组：X2 = 11.949, p = 0.154)。结论基于放射组学的联合模型是早期诊断乳腺癌化疗后心脏毒性的有效工具。它有助于检测乳腺癌患者化疗期间的心脏毒性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.