文章：

CT影像组学是否优于形态学评估用于pN0特征分析？一项结肠癌初步研究

Is CT Radiomics Superior to Morphological Evaluation for pN0 Characterization? A Pilot Study in Colon Cancer

原文发布日期：4 February 2024

DOI: 10.3390/cancers16030660

类型: Article

开放获取: 是

英文摘要：

The aim of this study was to compare CT radiomics and morphological features when assessing benign lymph nodes (LNs) in colon cancer (CC). This retrospective study included 100 CC patients (test cohort) who underwent a preoperative CT examination and were diagnosed as pN0 after surgery. Regional LNs were scored with a morphological Likert scale (NODE-SCORE) and divided into two groups: low likelihood (LLM: 0–2 points) and high likelihood (HLM: 3–7 points) of malignancy. TheT-test and the Mann–Whitney test were used to compare 107 radiomic features extracted from the two groups. Radiomic features were also extracted from primary lesions (PLs), and the receiver operating characteristic (ROC) was used to test a LN/PL ratio when assessing the LN’s status identified with radiomics and with the NODE-SCORE. An amount of 337 LNs were divided into 167 with LLM and 170 with HLM. Radiomics showed 15/107 features, with a significant difference (p< 0.02) between the two groups. The comparison of selected features between 81 PLs and the corresponding LNs showed all significant differences (p< 0.0001). According to the LN/PL ratio, the selected features recognized a higher number of LNs than the NODE-SCORE (p< 0.001). On validation of the cohort of 20 patients (10 pN0, 10 pN2), significant ROC curves were obtained for LN/PL busyness (AUC = 0.91; 0.69–0.99; 95% C.I.; andp< 0.001) and for LN/PL dependence entropy (AUC = 0.76; 0.52–0.92; 95% C.I.; andp= 0.03). The radiomics ratio between CC and LNs is more accurate for noninvasively discriminating benign LNs compared to CT morphological features.

摘要翻译： 

本研究旨在比较CT影像组学特征与形态学特征在评估结肠癌良性淋巴结时的效能。此项回顾性研究纳入了100例术前接受CT检查、术后病理诊断为pN0期的结肠癌患者（测试队列）。采用形态学Likert量表（NODE-SCORE）对区域淋巴结进行评分，并将其分为两组：低度恶性可能组（LLM：0-2分）和高度恶性可能组（HLM：3-7分）。通过T检验和Mann-Whitney检验比较两组提取的107个影像组学特征。同时从原发灶提取影像组学特征，并采用受试者工作特征曲线检验淋巴结/原发灶比值在评估影像组学特征与NODE-SCORE判定的淋巴结状态时的效能。337枚淋巴结被划分为167枚LLM淋巴结和170枚HLM淋巴结。影像组学分析显示15/107个特征在两组间存在显著差异（p<0.02）。81个原发灶与对应淋巴结的选定特征比较均显示显著差异（p<0.0001）。根据淋巴结/原发灶比值，选定特征识别的淋巴结数量显著多于NODE-SCORE评分（p<0.001）。在对20例患者（10例pN0期，10例pN2期）的验证队列中，淋巴结/原发灶繁忙度比值（AUC=0.91；95%CI：0.69-0.99；p<0.001）和淋巴结/原发灶依赖熵比值（AUC=0.76；95%CI：0.52-0.92；p=0.03）均获得显著的ROC曲线。相较于CT形态学特征，结肠癌原发灶与淋巴结的影像组学比值能更准确地进行无创性良性淋巴结鉴别。

原文链接：

Is CT Radiomics Superior to Morphological Evaluation for pN0 Characterization? A Pilot Study in Colon Cancer