Xianling Qian, Xiaoyan Ni, Gengyun Miao, Fang Wang, Changwu Zhou, Peng Huang, Yunfei Zhang, Lei Chen, Chun Yang, Mengsu Zeng
{"title":"基于核磁共振成像的放射组学特征与肝内胆管癌区域淋巴结转移及其临床预后的关系","authors":"Xianling Qian, Xiaoyan Ni, Gengyun Miao, Fang Wang, Changwu Zhou, Peng Huang, Yunfei Zhang, Lei Chen, Chun Yang, Mengsu Zeng","doi":"10.1002/jmri.29477","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Regional lymph node metastasis (LNM) assessment is crucial for predicting intrahepatic cholangiocarcinoma (iCCA) prognosis. However, imaging assessment has limitations for identifying LNM.</p><p><strong>Purpose: </strong>To investigate the association between MRI radiomics features, regional LNM status, and prognosis in iCCA.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Subjects: </strong>Two hundred ninety-six patients (male = 197) with surgically confirmed iCCA.</p><p><strong>Field strength/sequence: </strong>1.5 T and 3.0 T. DWI, T2WI, and contrast-enhanced T1WI.</p><p><strong>Assessment: </strong>Clinical information, radiologic, and MRI-based radiomics features associated with LNM status were collected to establish models. Performance of MRI, PET/CT, and the combined LNM models were compared in training (N = 207) and test (N = 89) datasets. Overall survival (OS) was compared based on LNM status.</p><p><strong>Statistical tests: </strong>The independent features were selected by 5-fold cross-validation. The performance of MRI, PET/CT, and the models was evaluated using the area under receiver operating characteristic curve (AUC). Univariable and multivariable Cox regression were used to identify independent variables for OS. Kaplan-Meier curves were compared with the log-rank test between LNM positive and negative groups. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Intrahepatic duct dilatation, enhancement pattern, and CA19-9 were independent clinicoradiologic features. The radiomics model was constructed by the independent radiomics features extracted from T2WI and delay phase T1WI. The combined LNM model showed AUC of 0.888, 0.884, and 0.811 in training, validation, and test cohorts with a positive net benefit. PET/CT exhibited similar sensitivity to the combined LNM model (0.750 vs. 0.733, P > 0.999) while the combined LNM model showed higher specificity (0.703 vs. 0.630, P = 0.039) in the test cohort. High risk of regional LNM was significantly associated with worse OS (median: 24 months) than low risk (median: 30 months, P < 0.0001).</p><p><strong>Data conclusions: </strong>The combined LNM model has the strongest correlation with LNM status for mass-forming iCCA patients.</p><p><strong>Evidence level: </strong>3 TECHNICAL EFFICACY: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":"997-1010"},"PeriodicalIF":3.3000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association Between MRI-Based Radiomics Features and Regional Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma and Its Clinical Outcome.\",\"authors\":\"Xianling Qian, Xiaoyan Ni, Gengyun Miao, Fang Wang, Changwu Zhou, Peng Huang, Yunfei Zhang, Lei Chen, Chun Yang, Mengsu Zeng\",\"doi\":\"10.1002/jmri.29477\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Regional lymph node metastasis (LNM) assessment is crucial for predicting intrahepatic cholangiocarcinoma (iCCA) prognosis. However, imaging assessment has limitations for identifying LNM.</p><p><strong>Purpose: </strong>To investigate the association between MRI radiomics features, regional LNM status, and prognosis in iCCA.</p><p><strong>Study type: </strong>Retrospective.</p><p><strong>Subjects: </strong>Two hundred ninety-six patients (male = 197) with surgically confirmed iCCA.</p><p><strong>Field strength/sequence: </strong>1.5 T and 3.0 T. DWI, T2WI, and contrast-enhanced T1WI.</p><p><strong>Assessment: </strong>Clinical information, radiologic, and MRI-based radiomics features associated with LNM status were collected to establish models. Performance of MRI, PET/CT, and the combined LNM models were compared in training (N = 207) and test (N = 89) datasets. Overall survival (OS) was compared based on LNM status.</p><p><strong>Statistical tests: </strong>The independent features were selected by 5-fold cross-validation. The performance of MRI, PET/CT, and the models was evaluated using the area under receiver operating characteristic curve (AUC). Univariable and multivariable Cox regression were used to identify independent variables for OS. Kaplan-Meier curves were compared with the log-rank test between LNM positive and negative groups. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Intrahepatic duct dilatation, enhancement pattern, and CA19-9 were independent clinicoradiologic features. The radiomics model was constructed by the independent radiomics features extracted from T2WI and delay phase T1WI. The combined LNM model showed AUC of 0.888, 0.884, and 0.811 in training, validation, and test cohorts with a positive net benefit. PET/CT exhibited similar sensitivity to the combined LNM model (0.750 vs. 0.733, P > 0.999) while the combined LNM model showed higher specificity (0.703 vs. 0.630, P = 0.039) in the test cohort. High risk of regional LNM was significantly associated with worse OS (median: 24 months) than low risk (median: 30 months, P < 0.0001).</p><p><strong>Data conclusions: </strong>The combined LNM model has the strongest correlation with LNM status for mass-forming iCCA patients.</p><p><strong>Evidence level: </strong>3 TECHNICAL EFFICACY: Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"997-1010\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29477\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29477","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Association Between MRI-Based Radiomics Features and Regional Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma and Its Clinical Outcome.
Background: Regional lymph node metastasis (LNM) assessment is crucial for predicting intrahepatic cholangiocarcinoma (iCCA) prognosis. However, imaging assessment has limitations for identifying LNM.
Purpose: To investigate the association between MRI radiomics features, regional LNM status, and prognosis in iCCA.
Study type: Retrospective.
Subjects: Two hundred ninety-six patients (male = 197) with surgically confirmed iCCA.
Field strength/sequence: 1.5 T and 3.0 T. DWI, T2WI, and contrast-enhanced T1WI.
Assessment: Clinical information, radiologic, and MRI-based radiomics features associated with LNM status were collected to establish models. Performance of MRI, PET/CT, and the combined LNM models were compared in training (N = 207) and test (N = 89) datasets. Overall survival (OS) was compared based on LNM status.
Statistical tests: The independent features were selected by 5-fold cross-validation. The performance of MRI, PET/CT, and the models was evaluated using the area under receiver operating characteristic curve (AUC). Univariable and multivariable Cox regression were used to identify independent variables for OS. Kaplan-Meier curves were compared with the log-rank test between LNM positive and negative groups. P < 0.05 was considered statistically significant.
Results: Intrahepatic duct dilatation, enhancement pattern, and CA19-9 were independent clinicoradiologic features. The radiomics model was constructed by the independent radiomics features extracted from T2WI and delay phase T1WI. The combined LNM model showed AUC of 0.888, 0.884, and 0.811 in training, validation, and test cohorts with a positive net benefit. PET/CT exhibited similar sensitivity to the combined LNM model (0.750 vs. 0.733, P > 0.999) while the combined LNM model showed higher specificity (0.703 vs. 0.630, P = 0.039) in the test cohort. High risk of regional LNM was significantly associated with worse OS (median: 24 months) than low risk (median: 30 months, P < 0.0001).
Data conclusions: The combined LNM model has the strongest correlation with LNM status for mass-forming iCCA patients.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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