通过临床放射组学模型预测晚期肝癌首次经动脉化疗栓塞的疗效。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Kai-Fei Zhao, Chao-Bang Xie, Yang Wu
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引用次数: 0

摘要

背景:肝细胞癌是一种常见的肿瘤,预后较差。早期干预至关重要;因此,需要良好的预后标记物来识别首次经动脉化疗栓塞(TACE)获益的患者。目的:探讨计算机断层扫描(CT)放射组学在预测晚期HCC患者首次TACE成功的有效性,并建立基于临床放射组学特征的早期预测模型。方法:对122例经TACE治疗的晚期HCC患者的资料进行分析。选择动脉和静脉CT图像上的肿瘤内和肿瘤周围区域提取放射学特征,并在训练队列中使用最小冗余最大相关进行筛选。然后,利用支持向量机构建模型。构建受试者工作特征曲线,根据曲线下面积(AUC)评价各模型的预测效果。结果:122例患者中,TACE治疗有效72例,无效50例。在放射组学模型中,训练组静脉期模型曲线下面积为0.867 (95%CI: 0.790-0.940),验证组为0.755(0.600-0.910),预测效果良好。多因素logistic回归结果显示术前甲胎蛋白水平(P = 0.01)是TACE发生的危险因素。将筛选的临床特征与放射学特征相结合,构建联合模型。该联合模型在训练组的AUC为0.92(0.87-0.95),在验证组的AUC为0.815(0.67-0.95)。结论:CT放射组学对肝癌患者首次TACE治疗的疗效预测有较好的价值。联合模型是预测晚期HCC患者首次TACE疗效的较好工具,可以为TACE患者的选择提供有效的预测工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prediction of the efficacy of first transarterial chemoembolization for advanced hepatocellular carcinoma via a clinical-radiomics model.

Background: Hepatocellular carcinoma (HCC) is a common tumor with a poor prognosis. Early intervention is essential; thus, good prognostic markers to identify patients who benefit from first transarterial chemoembolization (TACE) are needed.

Aim: To investigate the efficacy of computed tomography (CT) radiomics in predicting the success of the first TACE in patients with advanced HCC and to develop an early prediction model based on clinical radiomics features.

Methods: Data from 122 patients with advanced HCC treated with TACE were analyzed. Intratumoral and peritumoral areas on arterial and venous CT images were selected to extract radiomic features, which were screened in the training cohort using the minimum redundancy maximum correlation. Then, support vector machines were used to construct the model. To construct a receiver operating characteristic curve, the predictive efficacy of each model was evaluated on the basis of the area under the curve (AUC).

Results: Among the 122 patients, 72 patients were effectively treated via TACE, and in 50 patients, this treatment was ineffective. In the radiomics model, the areas under the curve of the venous phase model were 0.867 (95%CI: 0.790-0.940) in the training cohort and 0.755 (0.600-0.910) in the validation cohort, indicating good predictive efficacy. The multivariate logistic regression results indicated that preoperative alpha-fetoprotein levels (P = 0.01) were a risk factor for TACE. The screened clinical features were combined with the radiomic features to construct a combined model. This combined model had an AUC of 0.92 (0.87-0.95) in the training cohort and 0.815 (0.67-0.95) in the validation cohort.

Conclusion: CT radiomics has good value in predicting the efficacy of the first TACE treatment in patients with HCC. The combined model was a better tool for predicting the first TACE efficacy in patients with advanced HCC and could provide an efficient predictive tool to help with the selection of patients for TACE.

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来源期刊
World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
自引率
0.00%
发文量
3384
期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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