Radiomics Nomogram For Preoperative Prediction Research Articles

Preoperative radiomics nomogram for microvascular invasion prediction in hepatocellular carcinoma using contrast-enhanced CT.

To develop and validate a radiomics nomogram for preoperative prediction of microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). The study included 157 patients with histologically confirmed HCC with or without MVI, and 110 patients were allocated to the training dataset and 47 to the validation dataset. Baseline clinical factor (CF) data were collected from our medical records, and radiomics features were extracted from the artery phase (AP), portal venous phase (PVP) and delay phase (DP) of preoperatively acquired CT in all patients. Radiomics analysis included tumour segmentation, feature extraction, model construction and model evaluation. A final nomogram for predicting MVI of HCC was established. Nomogram performance was assessed via both calibration and discrimination statistics. Five AP features, seven PVP features and nine DP features were effective for MVI prediction in HCC radiomics signatures. PVP radiomics signatures exhibited better performance than AP and DP radiomics signatures in the validation datasets, with the AUC 0.793. In the clinical model, age, maximum tumour diameter, alpha-fetoprotein and hepatitis B antigen were effective predictors. The final nomogram integrated the PVP radiomics signature and four CFs. Good calibration was achieved for the nomogram in both the training and validated datasets, with respective C-indexes of 0.827 and 0.820. Decision curve analysis suggested that the proposed nomogram was clinically useful, with a corresponding net benefit of 0.357. The above-described radiomics nomogram can preoperatively predict MVI in patients with HCC and may constitute a usefully clinical tool to guide subsequent personalised treatment. • No previously reported study has utilised radiomics nomograms to preoperatively predict the MVI of HCC using 3D contrast-enhanced CT imaging. • The combined radiomics clinical factor (CF) nomogram for predicting MVI achieved superior performance than either the radiomics signature or the CF nomogram alone. • Nomograms combing PVP radiomics and CF may be useful as an imaging marker for predicting MVI of HCC preoperatively and could guide personalised treatment.

A Radiomics Nomogram for Preoperative Prediction of Microvascular Invasion in Hepatocellular Carcinoma

Background: Radiomics has emerged as a new approach that can help identify imaging information associated with tumor pathophysiology. We developed and validated a radiomics nomogram for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Methods: Two hundred and eight patients with pathologically confirmed HCC (training cohort: n = 146; validation cohort: n = 62) who underwent preoperative gadoxetic acid-enhanced magnetic resonance (MR) imaging were included. Least absolute shrinkage and selection operator logistic regression was applied to select features and construct signatures derived from MR images. Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and radiomics signatures associated with MVI, which were then incorporated into the predictive nomogram. The performance of the radiomics nomogram was evaluated by its calibration, discrimination, and clinical utility. Results: Higher α-fetoprotein level (p = 0.046), nonsmooth tumor margin (p = 0.003), arterial peritumoral enhancement (p < 0.001), and the radiomics signatures of hepatobiliary phase (HBP) T1-weighted images (p < 0.001) and HBP T1 maps (p < 0.001) were independent risk factors of MVI. The predictive model that incorporated the clinicoradiological factors and the radiomic features derived from HBP images outperformed the combination of clinicoradiological factors in the training cohort (area under the curves [AUCs] 0.943 vs. 0.850; p = 0.002), though the validation did not have a statistical significance (AUCs 0.861 vs. 0.759; p = 0.111). The nomogram based on the model exhibited C-index of 0.936 (95% CI 0.895–0.976) and 0.864 (95% CI 0.761–0.967) in the training and validation cohort, fitting well in calibration curves (p > 0.05). Decision curve analysis further confirmed the clinical usefulness of the nomogram. Conclusions: The nomogram incorporating clinicoradiological risk factors and radiomic features derived from HBP images achieved satisfactory preoperative prediction of the individualized risk of MVI in patients with HCC.

A radiomics nomogram for preoperatively predicting prognosis of patients in hepatocellular carcinoma

Background: Increasing studies have indicated that biomarkers based on quantitative radiomics features are related to clinical prognosis across a range of cancer types, but the association between radiomics and prognosis in hepatocellular carcinoma (HCC) is unclear. We aimed to develop and validate a radiomics nomogram for the preoperative prediction of prognosis for patients with HCC undergoing partial hepatectomy. Methods: In total, 177 patients were randomly divided into training (n=113) and validation (n=64) cohorts. A total number of 980 radiomics features were extracted from computed tomography images. And the least absolute shrinkage and selection operator algorithm was used to select the optimal features and build a radiomics signature in the training set. Besides, a radiomics nomogram was developed using multivariate regression analysis. The performance of the radiomics nomogram was estimated regarding its discrimination and calibration abilities, and clinical usefulness. Results: The radiomics signature was significantly associated with disease-free survival (DFS) (P Conclusions: The proposed radiomics nomogram showed excellent performance for the individualized and non-invasive estimation of DFS, which may help clinicians better identify patients with HBV-related HCC who can benefit from the surgery.

A radiomics nomogram for preoperative prediction of microvascular invasion risk in hepatitis B virus-related hepatocellular carcinoma.

We aimed to develop and validate a radiomics nomogram for preoperative prediction of microvascular invasion (MVI) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). A total of 304 eligible patients with HCC were randomly divided into training (n=184) and independent validation (n=120) cohorts. Portal venous and arterial phase computed tomography data of the HCCs were collected to extract radiomic features. Using the least absolute shrinkage and selection operator algorithm, the training set was processed to reduce data dimensions, feature selection, and construction of a radiomics signature. Then, a prediction model including the radiomics signature, radiologic features, and alpha-fetoprotein (AFP) level, as presented in a radiomics nomogram, was developed using multivariable logistic regression analysis. The radiomics nomogram was analyzed based on its discrimination ability, calibration, and clinical usefulness. Internal cohort data were validated using the radiomics nomogram. The radiomics signature was significantly associated with MVI status (P < 0.001, both cohorts). Predictors, including the radiomics signature, nonsmooth tumor margin, hypoattenuating halos, internal arteries, and alpha-fetoprotein level were reserved in the individualized prediction nomogram. The model exhibited good calibration and discrimination in the training and validation cohorts (C-index [95% confidence interval]: 0.846 [0.787-0.905] and 0.844 [0.774-0.915], respectively). Its clinical usefulness was confirmed using a decision curve analysis. The radiomics nomogram, as a noninvasive preoperative prediction method, shows a favorable predictive accuracy for MVI status in patients with HBV-related HCC.

Development and Validation of a Radiomics Nomogram for Preoperative Prediction of Lymph Node Metastasis in Colorectal Cancer.

To develop and validate a radiomics nomogram for preoperative prediction of lymph node (LN) metastasis in patients with colorectal cancer (CRC). The prediction model was developed in a primary cohort that consisted of 326 patients with clinicopathologically confirmed CRC, and data was gathered from January 2007 to April 2010. Radiomic features were extracted from portal venous-phase computed tomography (CT) of CRC. Lasso regression model was used for data dimension reduction, feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the predicting model, we incorporated the radiomics signature, CT-reported LN status, and independent clinicopathologic risk factors, and this was presented with a radiomics nomogram. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed. An independent validation cohort contained 200 consecutive patients from May 2010 to December 2011. The radiomics signature, which consisted of 24 selected features, was significantly associated with LN status (P < .001 for both primary and validation cohorts). Predictors contained in the individualized prediction nomogram included the radiomics signature, CT-reported LN status, and carcinoembryonic antigen level. Addition of histologic grade to the nomogram failed to show incremental prognostic value. The model showed good discrimination, with a C-index of 0.736 (C-index, 0.759 and 0.766 through internal validation), and good calibration. Application of the nomogram in the validation cohort still gave good discrimination (C-index, 0.778 [95% CI, 0.769 to 0.787]) and good calibration. Decision curve analysis demonstrated that the radiomics nomogram was clinically useful. This study presents a radiomics nomogram that incorporates the radiomics signature, CT-reported LN status, and clinical risk factors, which can be conveniently used to facilitate the preoperative individualized prediction of LN metastasis in patients with CRC.