手术切除的非小细胞肺癌瘤周放射组学的预后价值和病理相关性

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2024-09-01 DOI:10.1016/j.acra.2024.01.033

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引用次数: 0

摘要

理论依据和目标确定瘤周放射组学在预测手术切除非小细胞肺癌（NSCLC）总生存期（OS）方面的附加价值及其与病理结果的相关性：共纳入 526 例手术切除的 NSCLC 患者（191 例训练组、160 例内部验证组和 175 例外部验证组）。使用 CT 图像分割肿瘤边界 3、6、9 毫米距离内的肿瘤总体积（GTV）和瘤周体积（PTV）（PTV3、PTV6 和 PTV9），并提取放射学特征。利用训练队列构建了四个 OS 预后模型（GTV、GTV + PTV3、GTV + PTV6 和 GTV + PTV9）。利用验证队列评估了预后能力和特征重要性。比较了最重要瘤周特征值前 30 位和后 30 位的两组患者（每组 30 人）的病理结果：结果：GTV+ PTV3 模型的预测能力最高，在内部验证队列（C-index：0.666 vs. 0.616，P = 0.027）和外部验证队列（C-index：0.705 vs. 0.656，P = 0.048）中均高于 GTV 模型。最重要的特征是从 PTV3 提取的 GLDM_Dependence_Entropy。瘤周 GLDM_Dependence_Entropy 高与侵袭性组织学类型、肿瘤通过气隙扩散和肿瘤浸润淋巴细胞比例高相关（均为 P 结论：瘤周 GLDM_Dependence_Entropy 高与侵袭性组织学类型、肿瘤通过气隙扩散和肿瘤浸润淋巴细胞比例高相关：与单独使用 GTV 相比，GTV 和 PTV3 组合显示出更高的预后能力。瘤周放射学特征可能与各种病理预后因素有关。

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Prognostic Value and Pathological Correlation of Peritumoral Radiomics in Surgically Resected Non-Small Cell Lung Cancer

Rationale and Objectives

To determine the additional value of peritumoral radiomics in predicting overall survival (OS) in surgically resected non-small cell lung cancer (NSCLC) and its correlation with pathological findings.

Methods

A total of 526 patients with surgically resected NSCLC were included (191 training, 160 internal validation, and 175 external validation cohorts). CT images were used to segment the gross tumor volume (GTV) and peritumoral volume (PTV) within distances of 3, 6, 9 mm from the tumor boundary (PTV3, PTV6, and PTV9), and radiomic features were extracted. Four prognostic models for OS (GTV, GTV + PTV3, GTV + PTV6, and GTV + PTV9) were constructed using the training cohort. The prognostic ability and feature importance were evaluated using the validation cohorts. Pathological findings were compared between the two patient groups (n = 30 for each) having the top 30 and bottom 30 values of the most important peritumoral feature.

Results

The GTV + PTV3 models exhibited the highest predictive ability, which was higher than that of the GTV model in the internal validation cohort (C-index: 0.666 vs. 0.616, P = 0.027) and external validation cohort (C-index: 0.705 vs. 0.656, P = 0.048). The most important feature was GLDM_Dependence_Entropy, extracted from PTV3. High peritumoral GLDM_Dependence_Entropy was associated with a high proportion of invasive histological types, tumor spread through air spaces, and tumor-infiltrating lymphocytes (all P < 0.05).

Conclusion

The GTV and PTV3 combination demonstrated a higher prognostic ability, compared to GTV alone. Peritumoral radiomic features may be associated with various pathological prognostic factors.

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.