Abstract

PurposeTo establish and verify a predictive model involving multiparameter MRI and clinical manifestations for predicting synchronous lung metastases (SLM) in osteosarcoma.Materials and MethodsSeventy-eight consecutive patients with osteosarcoma (training dataset, n = 54; validation dataset, n = 24) were enrolled in our study. MRI features were extracted from the T1‐weighted image (T1WI), T2‐weighted image (T2WI), and contrast-enhanced T1-weighted image (CE-T1WI) of each patient. Least absolute shrinkage and selection operator (LASSO) regression and multifactor logistic regression were performed to select key features and build radiomics models in conjunction with logistic regression (LR) and support vector machine (SVM) classifiers. Eight individual models based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI+CE-T1WI, T2WI+CE-T1WI, T1WI+T2WI+CE-T1WI, and clinical features, as well as two combined models, were built. The area under the receiver operating characteristic curve (AUC), sensitivity and specificity were employed to assess the different models.ResultsTumor size was the most significant univariate clinical indicator (1). The AUC values of the LR predictive model based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI+CE-T1WI, T2WI+CE-T1WI, and T1WI+T2WI+CE-T1WI were 0.686, 0.85, 0.87, 0.879, 0.736, 0.85, and 0.914, respectively (2). The AUC values of the SVM predictive model based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI +CE-T1WI, T2WI +CE-T1WI, and T1WI+T2WI+CE-T1WI were 0.629, 0.829, 0.771, 0.879, 0.643, 0.829, and 0.929, respectively (3). The AUC values of the clinical, combined 1 (clinical and LR-radiomics) and combined 2 (clinical and SVM-radiomics) predictive models were 0.779, 0.957, and 0.943, respectively.ConclusionThe combined model exhibited good performance in predicting osteosarcoma SLM and may be helpful in clinical decision-making.

Highlights

  • Osteosarcoma is a highly prevalent primary bone malignancy

  • The AUC values of the logistic regression (LR) predictive model based on T1-weighted imaging (T1WI), T2weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI), T1WI+T2WI, T1WI +CE-T1WI, T2WI+CE-T1WI, and T1WI+T2WI+CE-T1WI were 0.686, 0.85, 0.87, 0.879, 0.736, 0.85, and 0.914, respectively [2]

  • The AUC values of the support vector machine (SVM) predictive model based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI +CE-T1WI, T2WI +CE-T1WI, and T1WI+T2WI+CE-T1WI were 0.629, 0.829, 0.771, 0.879, 0.643, 0.829, and 0.929, respectively [3]

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Summary

Introduction

Osteosarcoma is a highly prevalent primary bone malignancy. complete ablation of nonmetastatic high-grade osteosarcoma is possible in 60–70% of cases when treated with adjuvant and neoadjuvant multiagent chemotherapies in addition to surgery [1]. 20% of osteosarcoma patients exhibit metastasis at initial diagnosis (synchronous metastases) [2, 3]. The primary tumor is more resistant to chemotherapy in patients with synchronous metastases than in patients with localized disease at presentation [4]. Both the number of nodules and lobes are strong indicators of survival [5]. The best indicators of survival are tumor grade, tumor size, and distal metastases, which can be detected from biopsies and microscopic evaluations [6]. We developed and validated combined models according to multiparametric MRI and clinical features to predict synchronous lung metastases (SLM) in osteosarcoma

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