Abstract

To assess if quantitative integrated deep learning and radiomics features can predict the PD-L1 expression level in preoperative MRI of hepatocellular carcinoma (HCC) patients. The data in this study consist of 103 hepatocellular carcinoma patients who received immunotherapy in a single center. These patients were divided into a high PD-L1 expression group (30 patients) and a low PD-L1 expression group (73 patients). Both radiomics and deep learning features were extracted from their MRI sequence of T2-WI, which were merged into an integrative feature space for machine learning for the prediction of PD-L1 expression. The five-fold cross-validation was adopted to validate the performance of the model, while the AUC was used to assess the predictive ability of the model. Based on the five-fold cross-validation, the integrated model achieved the best prediction performance, with an AUC score of 0.897 ± 0.084, followed by the deep learning-based model with an AUC of 0.852 ± 0.043 then the radiomics-based model with AUC of 0.794 ± 0.035. The feature set integrating radiomics and deep learning features is more effective in predicting PD-L1 expression level than only one feature type. The integrated model can achieve fast and accurate prediction of PD-L1 expression status in preoperative MRI of HCC patients.

Highlights

  • Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide [1]

  • Previous studies have shown that the expression status of programmed death-ligand 1 (PD-L1) in tumors is related to the clinical outcome and treatment response of PD-L1 pathway inhibition [19,20,21,22,23,24,25], and it can be used as a predictive biomarker for immune checkpoint inhibitor (ICI) therapy [26,27,28]

  • We only use the deep learning model as a feature extractor, and integrate the deep learning features into the radiomics analysis model, which enriches the predictive power of the model and improves the overall performance of the model with limited training data

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Summary

Introduction

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide [1]. Immunotherapy by immune checkpoint inhibitor (ICI) has emerged as a crucial therapeutic option for improving the prognosis of various cancers [3,4,5,6,7,8]. This has demonstrated promising efficacy of treatment over conventional chemotherapy for different malignant tumors [9,10,11,12,13,14], including HCC [15,16], by triggering the antitumor immune response of T cells instead of directly targeting the tumor itself [17]. Clinical practice is urgently in need of a quick, reliable, and noninvasive method for assessing PD-L1 expression

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