Study on the value of enhanced CT-based radiomics and morphological features in predicting visceral pleural invasion in non-small cell lung cancer
Zhu Haonan1,2, Wang Ansheng1, Hong Haining1,2, Sang Haiwei1, Li Qicai1, Chen Liwei1, Yang Yifan1, Duan Guixin1
1Department of Thoracic Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China; 2Graduate School of Bengbu Medical College, Bengbu 233030, China
Abstract:Objective This study aimed to explore the efficacy of preoperative prediction of visceral pleural invasion (VPI) in patients with non-small cell lung cancer (NSCLC) based on enhanced CT radiomics and morphological features before operation. Methods A total of 220 patients with lung cancer treated in the First Affiliated Hospital of Bengbu Medical College from January 2019 to January 2021 were analyzed retrospectively, including 145 males and 75 females aged 43-89 (62.6±10.0) years old. According to the postoperative pathological examination, 90 cases were diagnosed with VPI, and 130 cases did not have VPI. According to the proportion of 4:1, the patients were randomly divided into training group (176 cases) and verification group (44 cases). The radiomics features were extracted based on the preoperative enhanced CT images. The LASSO-Logistic regression model was used to select the radiomics features with the highest correlation between arteriovenous phase and venous phase to establish the VPI prediction model. Independent sample t-test and χ2 test were used to screen clinical data, CT morphological features, and other related variables, which were combined with the final selection of the most relevant radiomics features to build a joint model. The working characteristic (ROC) curve of the subjects was drawn, and the area under the curve (AUC) was used to evaluate the prediction efficiency of the model for VPI in the training and verification groups. The Delong test was used to compare the AUC differences between models. Results Among the 1878 radiomics features extracted, the 10 most relevant radiomics features in the arterial and venous phases were selected and used to establish VPI prediction models. In the training and validation groups, the AUC values of the venous imaging group model were 0.867(95%CI 0.815-0.920) and 0.855(95%CI 0.746-0.964), respectively, which were greater than those of 0.844(95%CI 0.784-0.904) and 0.814(95%CI 0.677-0.951) in the arterial phase, and the differences between the groups were statistically significant (Z = 2.20, 2.07, all P values < 0.05). Significant differences were found in three CT morphological features, namely, cavity sign, spiculation sign, and pleural indentation sign, between patients with VPI and those without VPI (χ2 = 8.30, 7.87, 10.32, all P values < 0.05). There was no significant difference in baseline data between the training group and the validation group (all P values > 0.05). The combined model was constructed by using the final 10 highest venous phase radiomics features that were correlated and the above three CT morphological signs. The AUCs in the training and validation groups were 0.914(95%CI 0.875-0.953) and 0.884(95%CI 0.785-0.984), respectively, which were greater than those in the venous phase imaging model, and the AUC difference between the two models in the training and validation groups was statistically significant (Z = 3.09, 2.21, all P values < 0.05). The joint model had higher prediction efficiency for VPI. Conclusion Based on the radiomics features of enhanced CT venous phase images combined with cavity sign, spiculation sign and pleural indentation sign, the joint model of CT morphological signs can predict the occurrence of VPI in patients with non-small cell lung cancer before operation and assist clinical decision-making.
朱浩楠, 王安生, 洪海宁, 桑海威, 李其才, 陈力维, 杨逸凡, 段贵新. 基于增强CT影像组学及形态学征象对非小细胞肺癌脏层胸膜侵犯的预测价值研究[J]. 中华解剖与临床杂志, 2022, 27(4): 213-219.
Zhu Haonan, Wang Ansheng, Hong Haining, Sang Haiwei, Li Qicai, Chen Liwei, Yang Yifan, Duan Guixin. Study on the value of enhanced CT-based radiomics and morphological features in predicting visceral pleural invasion in non-small cell lung cancer. Chinese Journal of Anatomy and Clinics, 2022, 27(4): 213-219.
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