心外膜脂肪组织的放射组学参数可预测急性肺栓塞的死亡率。

IF 5.8 2区 医学 Q1 Medicine
Alexey Surov, Silke Zimmermann, Mattes Hinnerichs, Hans-Jonas Meyer, Anar Aghayev, Jan Borggrefe
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引用次数: 0

摘要

背景:准确预测急性肺栓塞(APE)的短期死亡率非常重要。本研究旨在分析心外膜脂肪组织(EAT)放射组学值在急性肺栓塞中的预后作用:研究共纳入 508 例患者,其中女性 209 例(42.1%),平均年龄(64.7 ± 14.8)岁。4.6%和12.4%的患者死亡(分别为7天和30天死亡率)。为了进行外部验证,进一步分析了 186 名患者。分别有 20.2% 和 27.7% 的患者死亡(7 天和 30 天死亡率)。每位患者在入院时都要进行 CTPA,然后再使用多层 CT 扫描仪进行治疗。一名训练有素的放射科医生在对患者结果保密的情况下,在专用工作站上使用 ImageJ 软件对 EAT 进行半自动分割。使用放射组学库提取放射组学特征。通过随机森林和特征排序对特征间的相关性和特征净化进行校正后,我们使用每位患者的 247 个特征建立了特征签名。总共确定了 26 种具有不同特征类别组合的特征组合。患者以 7:3 的比例被随机分配到训练队列和验证队列中。我们建立了两个模型(30 天死亡率和 7 天死亡率)。这些模型结合了七个不同图像特征类别的 13 个特征:我们将特征模型与验证队列(n = 169)进行了拟合,以检验模型的准确性。我们观察到,预测 30 天死亡率和 7 天死亡率的 AUC 分别为 0.776(CI 0.671-0.881)和 0.724(CI 0.628-0.820)。在验证队列中,这方面的总体预测正确率分别为 88% 和 79%。最后,独立外部验证队列的AUC分别为0.721(CI 0.633-0.808)和0.750(CI 0.657-0.842):EAT的放射组学参数与APE患者的死亡率密切相关:临床试验编号:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiomics parameters of epicardial adipose tissue predict mortality in acute pulmonary embolism.

Background: Accurate prediction of short-term mortality in acute pulmonary embolism (APE) is very important. The aim of the present study was to analyze the prognostic role of radiomics values of epicardial adipose tissue (EAT) in APE.

Methods: Overall, 508 patients were included into the study, 209 female (42.1%), mean age, 64.7 ± 14.8 years. 4.6%and 12.4% died (7- and 30-day mortality, respectively). For external validation, a cohort of 186 patients was further analysed. 20.2% and 27.7% died (7- and 30-day mortality, respectively). CTPA was performed at admission for every patient before any previous treatment on multi-slice CT scanners. A trained radiologist, blinded to patient outcomes, semiautomatically segmented the EAT on a dedicated workstation using ImageJ software. Extraction of radiomic features was applied using the pyradiomics library. After correction for correlation among features and feature cleansing by random forest and feature ranking, we implemented feature signatures using 247 features of each patient. In total, 26 feature combinations with different feature class combinations were identified. Patients were randomly assigned to a training and a validation cohort with a ratio of 7:3. We characterized two models (30-day and 7-day mortality). The models incorporate a combination of 13 features of seven different image feature classes.

Findings: We fitted the characterized models to a validation cohort (n = 169) in order to test accuracy of our models. We observed an AUC of 0.776 (CI 0.671-0.881) and an AUC of 0.724 (CI 0.628-0.820) for the prediction of 30-day mortality and 7-day mortality, respectively. The overall percentage of correct prediction in this regard was 88% and 79% in the validation cohorts. Lastly, the AUC in an independent external validation cohort was 0.721 (CI 0.633-0.808) and 0.750 (CI 0.657-0.842), respectively.

Interpretation: Radiomics parameters of EAT are strongly associated with mortality in patients with APE.

Clinical trial number: Not applicable.

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来源期刊
Respiratory Research
Respiratory Research RESPIRATORY SYSTEM-
CiteScore
9.70
自引率
1.70%
发文量
314
审稿时长
4-8 weeks
期刊介绍: Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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