Eur Radiol:放射组学模型中CT层厚预测非小细胞肺癌生存率的影响

2021-03-07 shaosai MedSci原创

在临床实践中,不同机构之间用于获取图像的CT层厚度通常有所差别,用于放射组学分析的最佳CT层厚度尚未确定。

    非小细胞肺癌(Non-small-cell lung cancer, NSCLC)因其病理、遗传和细胞异质性显著,因此患者预后差别较大。目前,临床上常规使用TNM分期系统对患者进行治疗方案制定和预后预测。虽然TNM分期使用方便且易于沟通,但在患者的精确划分方面存在局限性,因同一TNM分期的NSCLC患者预后差异极大。因此,我们需要建立额外的预测模型对患者进行进一步的风险分层。

    在这方面,使用从影像学数据中提取的高维定量特征的放射组学技术是一个很好的选择。已有多项研究证明放射组学模型在各种肺癌队列中预测总生存期(OS)、无病生存期(DFS)等方面性能良好,临床价值极高。然而,目前还没有针对肺癌放射组学分析的标准化CT采集方案的建议。CT参数如层厚、对比增强等都会影响放射组学特征的重复性。在临床实践中,不同机构之间用于获取图像的CT层厚度通常有所差别,用于放射组学分析的最佳CT层厚度尚未确定。


    近日,发表在European Radiology杂志的一项研究使用不同的CT层厚对NSCLC患者预后的预测进行评价,探讨了CT层厚度是否会影响NSCLC患者放射组学预后模型的表现。

    本研究纳入了2014年5月至2015年12月间311例行NSCLC手术切除的患者,对每位患者的1、3和5毫米层厚的CT图像进行了评价。 在每个层厚的CT图像上进行对肿瘤进行分割,并提取出总共94个放射学特征(形状、肿瘤强度和质地)。将研究人群按时间分为开发集(n = 185)和验证集(n = 126)来预测无病生存期(DFS)。分别从三个不同层厚的数据集(Rad-1,Rad-3和Rad-5)中构建了三个放射组学模型。使用C指标对三个层厚的数据集和混合层厚数据集的模型性能进行了评估及比较。

    在相应层厚的数据集上,开发集Rad1、Rad3和Rad5预测DFS的c指数分别为0.68、0.70和0.68(p=0.40-0.89),验证集的c指数分别为0.73、0.73和0.76 (p=0.27-0.90)。将模型应用于验证集的不同层厚数据时,模型的性能没有显著的改变(C指数, 0.73-0.76, 0.72-0.73, 0.75-0.76; p = 0.07-0.92)。在混合厚度数据集中模型的性能与验证集中相应层厚数据集(C-index, 0.72-0.75 vs. 0.73-0.76)中模型的性能相近或略低。

表1 在开发集中,使用不同层厚三种放射组学模型预测DFS的性能。

表2 在验证集中,使用不同层厚三种放射组学模型预测DFS的性能。

    CT层厚对预测非小细胞肺癌患者DFS的放射组学模型的性能没有显著影响,这为肺癌放射组学分析的标准化CT采集方案的制定和放射组学分析的最佳CT层厚的选择提供了新的指导和参考意见。


原始出处:

Sohee Park,Sang Min Lee,Seonok Kim,et al. Performance of radiomics models for survival prediction in non-small-cell lung cancer: influence of CT slice thickness.DOI:10.1007/s00330-020-07423-2

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2059963, encodeId=bef6205996377, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Wed May 12 02:48:52 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256817, encodeId=6418125681e30, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Tue Mar 09 03:48:52 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047897, encodeId=c1cf104e897d0, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 15:48:52 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946144, encodeId=8cc1946144c9, content=非常及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/F6ACA602293B51DFBD3C177D2FADBE65/100, createdBy=e1681996783, createdName=回到起点, createdTime=Sun Mar 07 13:00:38 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946142, encodeId=d81394614216, content=及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/F6ACA602293B51DFBD3C177D2FADBE65/100, createdBy=e1681996783, createdName=回到起点, createdTime=Sun Mar 07 12:57:31 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=2059963, encodeId=bef6205996377, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Wed May 12 02:48:52 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256817, encodeId=6418125681e30, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Tue Mar 09 03:48:52 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047897, encodeId=c1cf104e897d0, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 15:48:52 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946144, encodeId=8cc1946144c9, content=非常及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/F6ACA602293B51DFBD3C177D2FADBE65/100, createdBy=e1681996783, createdName=回到起点, createdTime=Sun Mar 07 13:00:38 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946142, encodeId=d81394614216, content=及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/F6ACA602293B51DFBD3C177D2FADBE65/100, createdBy=e1681996783, createdName=回到起点, createdTime=Sun Mar 07 12:57:31 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-03-07 CHANGE

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    2021-03-07 回到起点

    非常及时

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    2021-03-07 回到起点

    及时

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