Contrast-enhanced MRI-based intratumoral heterogeneity assessment for predicting lymph node metastasis in resectable pancreatic ductal adenocarcinoma.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-03-30 DOI:10.1186/s13244-025-01956-0

Junjian Shen, Qing Li, Lei Li, Tianyu Lu, Jun Han, Zongyu Xie, Peng Wang, Zirui Cao, Mengsu Zeng, Jianjun Zhou, Tianzhu Yu, Yaolin Xu, Haitao Sun

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引用次数: 0

Abstract

Objectives: To develop and validate a contrast-enhanced MRI-based intratumoral heterogeneity (ITH) model for predicting lymph node (LN) metastasis in resectable pancreatic ductal adenocarcinoma (PDAC).

Methods: Lesions were encoded into different habitats based on enhancement ratios at arterial, venous, and delayed phases of contrast-enhanced MRI. Habitat models on enhanced ratio mapping and single sequences, radiomic models, and clinical models were developed for evaluating LN metastasis. The performance of the models was evaluated via different metrics. Additionally, patients were stratified into high-risk and low-risk groups based on an ensembled model to assess prognosis after adjuvant therapy.

Results: We developed an ensembled radiomics-habitat-clinical (RHC) model that integrates radiomics, habitat, and clinical data for precise prediction of LN metastasis in PDAC. The RHC model showed strong predictive performance, with area under the curve (AUC) values of 0.805, 0.779, and 0.615 in the derivation, internal validation, and external validation cohorts, respectively. Using an optimal threshold of 0.46, the model effectively stratified patients, revealing significant differences in recurrence-free survival and overall survival (OS) (p = 0.004 and p < 0.001). Adjuvant therapy improved OS in the high-risk group (p = 0.004), but no significant benefit was observed in the low-risk group (p = 0.069).

Conclusion: We developed an MRI-based ITH model that provides reliable estimates of LN metastasis for resectable PDAC and may offer additional value in guiding clinical decision-making.

Critical relevance statement: This ensemble RHC model facilitates preoperative prediction of LN metastasis in resectable PDAC using contrast-enhanced MRI. This offers a foundation for enhanced prognostic assessment and supports the management of personalized adjuvant treatment strategies.

Key points: MRI-based habitat models can predict LN metastasis in PDAC. Both the radiomics model and clinical characteristics were useful for predicting LN metastasis in PDAC. The RHC models have the potential to enhance predictive accuracy and inform personalized therapeutic decisions.

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基于对比增强mri的肿瘤内异质性评估预测可切除胰腺导管腺癌淋巴结转移。

目的：建立并验证一种基于增强mri的肿瘤内异质性（ITH）模型，用于预测可切除胰导管腺癌（PDAC）的淋巴结（LN）转移。方法：根据造影增强MRI在动脉、静脉和延迟期的增强比例，将病变编码到不同的栖息地。建立了基于增强比值作图和单序列的生境模型、放射学模型和临床模型来评估淋巴结转移。通过不同的指标来评估模型的性能。此外，根据综合模型将患者分为高危和低危组，以评估辅助治疗后的预后。结果：我们建立了一个集成放射组学、栖息地和临床数据的集成放射组学-栖息地-临床（RHC）模型，用于精确预测PDAC患者的淋巴结转移。RHC模型具有较强的预测性能，推导、内部验证和外部验证队列的曲线下面积（AUC）分别为0.805、0.779和0.615。采用0.46的最佳阈值，该模型有效地对患者进行了分层，揭示了无复发生存率和总生存率（OS）的显著差异（p = 0.004和p）。结论：我们开发了一种基于mri的ITH模型，可为可切除的PDAC提供可靠的淋巴结转移估计，并可能为指导临床决策提供额外价值。关键相关性声明：该整体RHC模型有助于使用增强MRI预测可切除PDAC患者的淋巴结转移。这为增强预后评估和支持个性化辅助治疗策略的管理提供了基础。重点：基于mri的栖息地模型可以预测PDAC的淋巴结转移。放射组学模型和临床特征均可用于预测PDAC患者的淋巴结转移。RHC模型具有提高预测准确性和为个性化治疗决策提供信息的潜力。

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

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.