摘要
目的 探讨增强CT的影像组学模型在预测肝细胞癌(hepatocellular carcinoma,HCC)经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)联合索拉菲尼治疗后短期疗效(6个月内)中的价值。方法 回顾性分析159例TACE联合索拉菲尼治疗的肝癌患者的临床、病理及术前CT图像,根据改良后实体瘤疗效评价标准(modified response evaluation criteria in solid tumors,mRECIST)对介入术后6个月肿瘤局部控制率进行评估。提取动脉期和门脉期的影像组学特征并构建影像组学模型。根据术前一般临床危险因素、基本影像特征,建立术前临床模型。将影像组学模型加入术前临床模型,组成联合模型。分别绘制3个模型的受试者工作特征曲线(ROC),并分别计算曲线下面积(AUC)。结果 从1 708个影像组学特征中共筛选出11个影像组学特征值建立影像组学模型,训练组及验证组模型AUC分为0.945、0.918。临床因素除了肿瘤最大径线和肿瘤数目外,差异有统计学意义(P <0.05),其余差异无统计学意义(P> 0.05),二者构建的临床模型训练组及验证组的AUC分别为0.811、0.857。联合模型训练组及验证组AUC分别为0.958、0.95。结论 影像组学模型是预测TACE联合索拉菲尼短期疗效的一个强有力的独立预测因素,能明显提高术前临床模型的预测能力,可在TACE联合索拉菲尼治疗前筛选出进展危险性较高的患者,帮助临床医生制定个性化的治疗及随访方案,改善患者预后。
Objective To investigate the value of enhanced CT radiomics model in predicting the shortterm efficacy( within 6 months) of TACE combined with sorafenib in hepatocellular carcinoma.Method The clinical,pathological and preoperative CT images of 159 HCC patients treated with TACE combined with solafenib were retrospectively analyzed.Local tumor control rate was assessed according to the modified Response Evalaution Criteria in Solid Tumors( mRECIST) 6 months later.The imaging features of arterial and portal phases were extracted to establish radiomics model.The general preoperative clinical risk factors and basic imaging features were analyzed to establish a preoperative clinical model.Radiomics model were added to the preoperative clinical model to form a combined model.The receiver operating characteristic curves(ROC) of the three models were drawn and calculate the area under the curve(AUC) respectively.Results A total of 11 feature values were selected from1 708 radiomic features to establish the raduomics model.The AUC of training group and the validation group was 0.945 and 0.918 respectively.Except the maximum diameter line and number of tumors,the differences were statistically significant(P 0.05).The AUC of the clinical model training group and the validation group was 0.811 and 0.857 respectively.The AUC of the combined model training group is 0.958,and that of validation group is about 0.95.Conclusion The radiomics model constructed in this study is a powerful independent predictor for predicting the short-term efficacy of TACE combined with sorafenib,which can significantly improve the predictive ability of preoperative clinical model,screen patients with higher risk of progression before TACE combined with sorafenib treatment,and help clinicians to develop personalized treatment and follow-up plan to improve the prognosis of patients.
作者
段茜婷
王关顺
丁荣
王娜
寸红丽
杨泠
DUAN Qianting;WANG Guanshun;DING Rong;WANG Na;CUN Hongli;YANG Ling(Dept.of Radiology,The 3rd Affiliated Hospital of Kunming Medical University/Yunnan Tumor Hospital,Kunming Yunnan 650118,China)
出处
《昆明医科大学学报》
CAS
2023年第1期128-134,共7页
Journal of Kunming Medical University
基金
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(202201AY070001-159)
云南省教育厅科学研究基金资助项目(2021J0261)。
关键词
肝细胞肝癌
影像组学
索拉菲尼
肝动脉化疗栓塞
Hepatocellular carcinoma
Radiomics
Sorafenib
Transcatheter arterial chemoembolization
