Abstract

ObjectivesTo identify the relatively invariable radiomics features as essential characteristics during the growth process of metastatic pulmonary nodules with a diameter of 1 cm or smaller from colorectal cancer (CRC).MethodsThree hundred and twenty lung nodules were enrolled in this study (200 CRC metastatic nodules in the training cohort, 60 benign nodules in the verification cohort 1, 60 CRC metastatic nodules in the verification cohort 2). All the nodules were divided into four groups according to the maximum diameter: 0 to 0.25 cm, 0.26 to 0.50 cm, 0.51 to 0.75 cm, 0.76 to 1.0 cm. These pulmonary nodules were manually outlined in computed tomography (CT) images with ITK-SNAP software, and 1724 radiomics features were extracted. Kruskal-Wallis test was performed to compare the four different levels of nodules. Cross-validation was used to verify the results. The Spearman rank correlation coefficient is calculated to evaluate the correlation between features.ResultsIn training cohort, 90 features remained stable during the growth process of metastasis nodules. In verification cohort 1, 293 features remained stable during the growth process of benign nodules. In verification cohort 2, 118 features remained stable during the growth process of metastasis nodules. It is concluded that 20 features remained stable in metastatic nodules (training cohort and verification cohort 2) but not stable in benign nodules (verification cohort 1). Through the cross-validation (n=100), 11 features remained stable more than 90 times.ConclusionsThis study suggests that a small number of radiomics features from CRC metastatic pulmonary nodules remain relatively stable from small to large, and they do not remain stable in benign nodules. These stable features may reflect the essential characteristics of metastatic nodules and become a valuable point for identifying metastatic pulmonary nodules from benign nodules.

Highlights

  • Colorectal cancer (CRC) is the third most common malignant tumor in the world [1], and about 5% to 15% of colorectal patients are accompanied by lung metastases [2]

  • Because chest computed tomography (CT) scan is recommended for the detection of lung nodules in primary staging and postoperative surveillance [5], an increasing number of CRC patients are found to have indeterminate pulmonary nodules (IPNs), and approximately 30% of them eventually proved to be metastatic during the follow-up [6]

  • The inclusion criteria were: 1) With metastatic pulmonary nodules confirmed by histopathology or multiple metastases identified on thoracic CT. 2) The diameter of the nodule is ≤1 cm

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Summary

Introduction

Colorectal cancer (CRC) is the third most common malignant tumor in the world [1], and about 5% to 15% of colorectal patients are accompanied by lung metastases [2]. Because chest computed tomography (CT) scan is recommended for the detection of lung nodules in primary staging and postoperative surveillance [5], an increasing number of CRC patients are found to have indeterminate pulmonary nodules (IPNs), and approximately 30% of them eventually proved to be metastatic during the follow-up [6]. Most of these nodules are

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