| 孙潇,丁瑞,马丽,李文玲,张怀瑢,朱力.门静脉期CT瘤周影像组学预测胃腺癌脉管侵犯[J].中国医学影像技术,2025,41(6):928~932 |
| 门静脉期CT瘤周影像组学预测胃腺癌脉管侵犯 |
| Portal-venous phase CT peritumoral radiomics for predicting lymphovascular invasion of gastric adenocarcinoma |
| 投稿时间：2024-12-16 修订日期：2025-03-06 |
| DOI：10.13929/j.issn.1003-3289.2025.06.017 |
| 中文关键词: 胃肿瘤 肿瘤侵袭性 影像组学 体层摄影术,X线计算机 |
| 英文关键词:gastric neoplasms neoplasm invasiveness radiomics tomography, X-ray computed |
| 基金项目:宁夏自然科学基金(2024AAC03560)、宁夏医科大学总医院医工专项资助项目(NYZYYG-002)、宁夏重点研发计划项目(2022BEG02025)。 |
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| 中文摘要: |
| 目的 观察门静脉期CT瘤周影像组学预测胃腺癌脉管侵犯(LVI)的价值。方法 纳入351例胃腺癌,以7 ∶ 3比例划分训练集(n=246)与测试集(n=105);于门静脉期增强CT中手动逐层勾画肿瘤ROI,并外扩1、3、5 mm获得瘤周ROI,提取其影像组学特征;分别建立临床-CT、肿瘤及瘤周1 mm、3 mm、5 mm影像组学模型及综合模型列线图,比较其预测LVI效能;采用校准曲线评价各模型预测LVI与病理所见LVI的一致性;以决策曲线分析(DCA)评价各模型的临床净获益。结果 临床-CT模型,肿瘤、瘤周1 mm、3 mm、5 mm影像组学及综合模型预测训练集胃腺癌LVI的曲线下面积分别为0.741、0.732、0.713、0.728、0.708及0.755,在测试集分别为0.748、0.725、0.759、0.724、0.704及0.764,以综合模型预测效能最高,且具有良好校准度及临床实用性。结论 门静脉期CT瘤周影像组学预测胃腺癌LVI具有较好效能;联合CT、肿瘤及瘤周影像组学特征能进一步提升预测效能。 |
| 英文摘要: |
| Objective To explore value of peritumoral radiomics models for predicting lymphovascular invasion (LVI) of gastric adenocarcinoma based on portal-venous phase enhanced CT images. Methods Totally 351 patients with gastric adenocarcinoma were collected and randomly divided into training set (n=246) and test set (n=105) at a ratio of 7 ∶ 3. ROI of tumors were manually delineated on portal-venous phase enhanced CT images, then radiomics features of tumoral areas and peritumoral areas (1, 3 and 5 mm expanded from lesions) were extracted, respectively. Clinical-CT, tumoral and peritumoral (1 mm, 3 mm, 5 mm) radiomics and comprehensive model nomograms were established, and their predictive performances for LVI were compared. Calibration curve was used to evaluate the consistency between the predicted and actual LVI of gastric adenocarcinoma, while decision curve analysis (DCA) was used to assess the net clinical benefit of each model. Results The area under the curve of clinical-CT, tumoral, peritumoral (1 mm, 3 mm, 5 mm) radiomics models and the comprehensive model for predicting LVI in training set was 0.741, 0.732, 0.713, 0.728, 0.708 and 0.755, respectively, which in test set was 0.748, 0.725, 0.759, 0.724, 0.704 and 0.764, respectively. The comprehensive model demonstrated the highest prediction efficiency, also good calibration and clinical practicability. Conclusion Portal-venous phase CT peritumoral radiomics models could be used to predict LVI of gastric adenocarcinoma. Combining with CT features, tumoral and optimal peritumoral radiomics features could further improve predictive efficiency. |
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