{"title":"使用基于人工智能的磁共振成像放射组学预测食管鳞状细胞癌对放化疗的病理完全反应。","authors":"Atsushi Hirata, Koichi Hayano, Toru Tochigi, Yoshihiro Kurata, Tadashi Shiraishi, Nobufumi Sekino, Akira Nakano, Yasunori Matsumoto, Takeshi Toyozumi, Masaya Uesato, Gaku Ohira","doi":"10.3748/wjg.v31.i36.111293","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Advanced esophageal squamous cell carcinoma (ESCC) has an extremely poor prognosis. Preoperative chemoradiotherapy (CRT) can significantly prolong survival, especially in those who achieve pathological complete response (pCR). However, the pretherapeutic prediction of pCR remains challenging.</p><p><strong>Aim: </strong>To predict pCR and survival in ESCC patients undergoing CRT using an artificial intelligence (AI)-based diffusion-weighted magnetic resonance imaging (DWI-MRI) radiomics model.</p><p><strong>Methods: </strong>We retrospectively analyzed 70 patients with ESCC who underwent curative surgery following CRT. For each patient, pre-treatment tumors were semi-automatically segmented in three dimensions from DWI-MRI images (<i>b</i> = 0, 1000 second/mm²), and a total of 76 radiomics features were extracted from each segmented tumor. Using these features as explanatory variables and pCR as the objective variable, machine learning models for predicting pCR were developed using AutoGluon, an automated machine learning library, and validated by stratified double cross-validation.</p><p><strong>Results: </strong>pCR was achieved in 15 patients (21.4%). Apparent diffusion coefficient skewness demonstrated the highest predictive performance [area under the curve (AUC) = 0.77]. Gray-level co-occurrence matrix (GLCM) entropy (<i>b</i> = 1000 second/mm²) was an independent prognostic factor for relapse-free survival (RFS) (hazard ratio = 0.32, <i>P</i> = 0.009). In Kaplan-Meier analysis, patients with high GLCM entropy showed significantly better RFS (<i>P</i> < 0.001, log-rank). The best-performing machine learning model achieved an AUC of 0.85. The predicted pCR-positive group showed significantly better RFS than the predicted pCR-negative group (<i>P</i> = 0.007, log-rank).</p><p><strong>Conclusion: </strong>AI-based radiomics analysis of DWI-MRI images in ESCC has the potential to accurately predict the effect of CRT before treatment and contribute to constructing optimal treatment strategies.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 36","pages":"111293"},"PeriodicalIF":5.4000,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476672/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predicting pathological complete response to chemoradiotherapy using artificial intelligence-based magnetic resonance imaging radiomics in esophageal squamous cell carcinoma.\",\"authors\":\"Atsushi Hirata, Koichi Hayano, Toru Tochigi, Yoshihiro Kurata, Tadashi Shiraishi, Nobufumi Sekino, Akira Nakano, Yasunori Matsumoto, Takeshi Toyozumi, Masaya Uesato, Gaku Ohira\",\"doi\":\"10.3748/wjg.v31.i36.111293\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Advanced esophageal squamous cell carcinoma (ESCC) has an extremely poor prognosis. Preoperative chemoradiotherapy (CRT) can significantly prolong survival, especially in those who achieve pathological complete response (pCR). However, the pretherapeutic prediction of pCR remains challenging.</p><p><strong>Aim: </strong>To predict pCR and survival in ESCC patients undergoing CRT using an artificial intelligence (AI)-based diffusion-weighted magnetic resonance imaging (DWI-MRI) radiomics model.</p><p><strong>Methods: </strong>We retrospectively analyzed 70 patients with ESCC who underwent curative surgery following CRT. For each patient, pre-treatment tumors were semi-automatically segmented in three dimensions from DWI-MRI images (<i>b</i> = 0, 1000 second/mm²), and a total of 76 radiomics features were extracted from each segmented tumor. Using these features as explanatory variables and pCR as the objective variable, machine learning models for predicting pCR were developed using AutoGluon, an automated machine learning library, and validated by stratified double cross-validation.</p><p><strong>Results: </strong>pCR was achieved in 15 patients (21.4%). Apparent diffusion coefficient skewness demonstrated the highest predictive performance [area under the curve (AUC) = 0.77]. Gray-level co-occurrence matrix (GLCM) entropy (<i>b</i> = 1000 second/mm²) was an independent prognostic factor for relapse-free survival (RFS) (hazard ratio = 0.32, <i>P</i> = 0.009). In Kaplan-Meier analysis, patients with high GLCM entropy showed significantly better RFS (<i>P</i> < 0.001, log-rank). The best-performing machine learning model achieved an AUC of 0.85. The predicted pCR-positive group showed significantly better RFS than the predicted pCR-negative group (<i>P</i> = 0.007, log-rank).</p><p><strong>Conclusion: </strong>AI-based radiomics analysis of DWI-MRI images in ESCC has the potential to accurately predict the effect of CRT before treatment and contribute to constructing optimal treatment strategies.</p>\",\"PeriodicalId\":23778,\"journal\":{\"name\":\"World Journal of Gastroenterology\",\"volume\":\"31 36\",\"pages\":\"111293\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-09-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476672/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3748/wjg.v31.i36.111293\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3748/wjg.v31.i36.111293","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Predicting pathological complete response to chemoradiotherapy using artificial intelligence-based magnetic resonance imaging radiomics in esophageal squamous cell carcinoma.
Background: Advanced esophageal squamous cell carcinoma (ESCC) has an extremely poor prognosis. Preoperative chemoradiotherapy (CRT) can significantly prolong survival, especially in those who achieve pathological complete response (pCR). However, the pretherapeutic prediction of pCR remains challenging.
Aim: To predict pCR and survival in ESCC patients undergoing CRT using an artificial intelligence (AI)-based diffusion-weighted magnetic resonance imaging (DWI-MRI) radiomics model.
Methods: We retrospectively analyzed 70 patients with ESCC who underwent curative surgery following CRT. For each patient, pre-treatment tumors were semi-automatically segmented in three dimensions from DWI-MRI images (b = 0, 1000 second/mm²), and a total of 76 radiomics features were extracted from each segmented tumor. Using these features as explanatory variables and pCR as the objective variable, machine learning models for predicting pCR were developed using AutoGluon, an automated machine learning library, and validated by stratified double cross-validation.
Results: pCR was achieved in 15 patients (21.4%). Apparent diffusion coefficient skewness demonstrated the highest predictive performance [area under the curve (AUC) = 0.77]. Gray-level co-occurrence matrix (GLCM) entropy (b = 1000 second/mm²) was an independent prognostic factor for relapse-free survival (RFS) (hazard ratio = 0.32, P = 0.009). In Kaplan-Meier analysis, patients with high GLCM entropy showed significantly better RFS (P < 0.001, log-rank). The best-performing machine learning model achieved an AUC of 0.85. The predicted pCR-positive group showed significantly better RFS than the predicted pCR-negative group (P = 0.007, log-rank).
Conclusion: AI-based radiomics analysis of DWI-MRI images in ESCC has the potential to accurately predict the effect of CRT before treatment and contribute to constructing optimal treatment strategies.
期刊介绍：
The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.
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