A radiomics-based model for predicting lymph nodes metastasis of pancreatic ductal adenocarcinoma: a multicenter study.

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

Insights into Imaging Pub Date : 2025-06-27 DOI:10.1186/s13244-025-02025-2

Liwen Zhu, Ben Zhao, Tianyi Xia, Di Chang, Cong Xia, Mengqiu Liu, Ridong Li, Buyue Cao, Yue Qiu, Yaoyao Yu, Shuwei Zhou, Huayu Chen, Wu Cai, Zhimin Ding, Chunqiang Lu, Tianyu Tang, Yang Song, Yuancheng Wang, Jing Ye, Ying Liu, Shenghong Ju

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引用次数: 0

Abstract

Purpose: To develop a radiomics model to predict lymph nodes metastasis (LNM) in patients with pancreatic ductal adenocarcinoma (PDAC) and assess its value for clinical management.

Methods: Patients with pathologically confirmed PDAC from four centers were retrospectively enrolled and split into four cohorts: training (n = 192), validation (n = 82), testing (n = 100), and clinical utilization (n = 163). A radiomics model was constructed based on contrast-enhanced CT (CECT) to predict LNM, and its performance was evaluated using the areas under the curve (AUC). Kaplan-Meier analysis was used to assess the prognostic and therapeutic decision-assisting value of the radiomics model.

Results: A total of 437 patients (mean age: 63.1 years ± 9.2 standard deviation; 253 men) were included. The radiomics model outperformed other models with AUCs of 0.84, 0.82, and 0.78 in the training, validation, and testing cohorts (all p < 0.05), respectively. LNM predicted by the radiomics model was significantly associated with overall survival (p < 0.001). Kaplan-Meier analysis revealed that patients with a higher risk of LNM also had worse outcomes (all p < 0.05). Additionally, among the high-risk subgroup identified by the radiomics model in the clinical utilization cohort, patients who underwent dissection of ≥ 15 lymph nodes exhibited better overall survival compared to those with fewer lymph nodes dissected (p = 0.002).

Conclusion: The radiomics model we constructed demonstrated impressive performance in predicting LNM and prognosis, suggesting its potential for optimizing the clinical management of PDAC.

Critical relevance statement: This radiomics model can predict the risk of lymph nodes metastasis and prognosis of patients in pancreatic ductal adenocarcinoma and has potential value in selecting patients who can benefit from different extents of lymph nodes dissection.

Key points: Thorough lymph node dissection is important for achieving the best prognosis in pancreatic ductal adenocarcinoma (PDAC). The radiomics model can accurately predict lymph node status and stratify patients' prognosis. This radiomics model enhances the clinical management of PDAC.

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基于放射组学的胰腺导管腺癌淋巴结转移预测模型：一项多中心研究。

目的：建立预测胰腺导管腺癌（PDAC）患者淋巴结转移（LNM）的放射组学模型，并评估其在临床治疗中的价值。方法：回顾性纳入4个中心病理证实的PDAC患者，分为4个队列：训练组（n = 192）、验证组（n = 82）、测试组（n = 100）和临床应用组（n = 163）。建立基于对比增强CT （CECT）的放射组学模型预测LNM，并利用曲线下面积（AUC）评价其性能。Kaplan-Meier分析用于评估放射组学模型的预后和治疗决策辅助价值。结果：共437例患者(平均年龄：63.1岁±9.2标准差；包括253名男性)。在训练组、验证组和测试组中，放射组学模型的auc分别为0.84、0.82和0.78，优于其他模型（均为p）。结论：我们构建的放射组学模型在预测LNM和预后方面表现出色，表明其在优化PDAC临床管理方面具有潜力。关键相关性声明：该放射组学模型可以预测胰腺导管腺癌患者的淋巴结转移风险和预后，在选择可以从不同程度淋巴结清扫中获益的患者方面具有潜在价值。重点：彻底的淋巴结清扫是胰管腺癌（PDAC）获得最佳预后的重要因素。放射组学模型可以准确预测淋巴结状态，对患者的预后进行分层。该放射组学模型增强了PDAC的临床管理。

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.