微波消融术前预测结直肠肝转移瘤局部肿瘤进展的术前磁共振成像放射学分析。

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-05-16 DOI:10.1080/02656736.2024.2349059
Angelo Della Corte, Martina Mori, Francesca Calabrese, Diego Palumbo, Francesca Ratti, Gabriele Palazzo, Alessandro Pellegrini, Domenico Santangelo, Monica Ronzoni, Emiliano Spezi, Antonella Del Vecchio, Claudio Fiorino, Luca Aldrighetti, Francesco De Cobelli
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引用次数: 0

摘要

目的放射组学可帮助预测结直肠肝转移(CLM)患者的预后。CT 可提供一致的数据,但 MRI 可提供的数据有限。本研究评估了磁共振成像衍生的放射学特征(RFs)预测微波消融(MWA)治疗的CLM患者局部无肿瘤进展生存期(LTPFS)的能力:方法:对2015年9月至2022年2月期间在一家机构接受微波消融治疗的所有术前有钆醋酸-MRI的CLM患者进行评估。对术前信息进行回顾性检索。两名观察者在T2和T1-肝胆相(T1-HBP)扫描上手动分割CLM。经过观察者间变异性测试,148/182 个 RFs 在 T1-HBP 上显示出稳健性,141/182 个 RFs 在 T2 上显示出稳健性(ICC > 0.7)。Cox 多变量分析用于建立临床(CLIN-mod)、放射学(RAD-T1、RAD-T2)和组合(COMB-T1、COMB-T2)模型,以预测 LTPFS:结果:共评估了 76 个 CLM(43 名患者)。中位随访时间为 14 个月。CLIN-mod由最小消融边缘(MAM)、节段内进展和原发肿瘤分级组成,在预测LTPFS方面表现出中等程度的鉴别力(AUC = 0.89,p = 0.0001)。RAD-T1 和 RAD-T2 都能预测 LTPFS:(RAD-T1:AUC = 0.83,p = 0.0003;RAD-T2:AUC = 0.79,p = 0.001)。组合模型的性能最强(COMB-T1:AUC = 0.98,p = 0.0001;COMB-T2:AUC = 0.95,p = 0.0003)。两个组合模型都包括 MAMs 和肿瘤回归分级;COMB-T1 还具有信号强度第 10 百分位数的特征,而 COMB-T2 则具有肿瘤平整度的特征:结论:基于核磁共振成像的CLM放射学评估是可行的,而且可能有助于LTP预测。在 LTPFS 预测方面,综合模型优于单独的临床模型或放射学模型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preoperative MRI radiomic analysis for predicting local tumor progression in colorectal liver metastases before microwave ablation.

Purpose: Radiomics may aid in predicting prognosis in patients with colorectal liver metastases (CLM). Consistent data is available on CT, yet limited data is available on MRI. This study assesses the capability of MRI-derived radiomic features (RFs) to predict local tumor progression-free survival (LTPFS) in patients with CLMs treated with microwave ablation (MWA).

Methods: All CLM patients with pre-operative Gadoxetic acid-MRI treated with MWA in a single institution between September 2015 and February 2022 were evaluated. Pre-procedural information was retrieved retrospectively. Two observers manually segmented CLMs on T2 and T1-Hepatobiliary phase (T1-HBP) scans. After inter-observer variability testing, 148/182 RFs showed robustness on T1-HBP, and 141/182 on T2 (ICC > 0.7).Cox multivariate analysis was run to establish clinical (CLIN-mod), radiomic (RAD-T1, RAD-T2), and combined (COMB-T1, COMB-T2) models for LTPFS prediction.

Results: Seventy-six CLMs (43 patients) were assessed. Median follow-up was 14 months. LTP occurred in 19 lesions (25%).CLIN-mod was composed of minimal ablation margins (MAMs), intra-segment progression and primary tumor grade and exhibited moderately high discriminatory power in predicting LTPFS (AUC = 0.89, p = 0.0001). Both RAD-T1 and RAD-T2 were able to predict LTPFS: (RAD-T1: AUC = 0.83, p = 0.0003; RAD-T2: AUC = 0.79, p = 0.001). Combined models yielded the strongest performance (COMB-T1: AUC = 0.98, p = 0.0001; COMB-T2: AUC = 0.95, p = 0.0003). Both combined models included MAMs and tumor regression grade; COMB-T1 also featured 10th percentile of signal intensity, while tumor flatness was present in COMB-T2.

Conclusion: MRI-based radiomic evaluation of CLMs is feasible and potentially useful for LTP prediction. Combined models outperformed clinical or radiomic models alone for LTPFS prediction.

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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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