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- Title
A radiomics approach to predict lymph node metastasis and clinical outcome of intrahepatic cholangiocarcinoma.
- Authors
Ji, Gu-Wei; Zhu, Fei-Peng; Zhang, Yu-Dong; Liu, Xi-Sheng; Wu, Fei-Yun; Wang, Ke; Xia, Yong-Xiang; Zhang, Yao-Dong; Jiang, Wang-Jie; Li, Xiang-Cheng; Wang, Xue-Hao
- Abstract
<bold>Objectives: </bold>This study was conducted in order to establish and validate a radiomics model for predicting lymph node (LN) metastasis of intrahepatic cholangiocarcinoma (IHC) and to determine its prognostic value.<bold>Methods: </bold>For this retrospective study, a radiomics model was developed in a primary cohort of 103 IHC patients who underwent curative-intent resection and lymphadenectomy. Radiomics features were extracted from arterial phase computed tomography (CT) scans. A radiomics signature was built based on highly reproducible features using the least absolute shrinkage and selection operator (LASSO) method. Multivariate logistic regression analysis was adopted to establish a radiomics model incorporating radiomics signature and other independent predictors. Model performance was determined by its discrimination, calibration, and clinical usefulness. The model was internally validated in 52 consecutive patients.<bold>Results: </bold>The radiomics signature comprised eight LN-status-related features and showed significant association with LN metastasis in both cohorts (p < 0.001). A radiomics nomogram that incorporates radiomics signature and CA 19-9 level showed good calibration and discrimination in the primary cohort (AUC 0.8462) and validation cohort (AUC 0.8921). Promisingly, the radiomics nomogram yielded an AUC of 0.9224 in the CT-reported LN-negative subgroup. Decision curve analysis confirmed the clinical utility of this nomogram. High risk for metastasis portended significantly lower overall and recurrence-free survival than low risk for metastasis (both p < 0.001). The radiomics nomogram was an independent preoperative predictor of overall and recurrence-free survival.<bold>Conclusions: </bold>Our radiomics model provided a robust diagnostic tool for prediction of LN metastasis, especially in CT-reported LN-negative IHC patients, that may facilitate clinical decision-making.<bold>Key Points: </bold>• The radiomics nomogram showed good performance for prediction of LN metastasis in IHC patients, particularly in the CT-reported LN-negative subgroup. • Prognosis of high-risk patients remains dismal after curative-intent resection. • The radiomics model may facilitate clinical decision-making and define patient subsets benefiting most from surgery.
- Subjects
LYMPH nodes; LOGISTIC regression analysis; METASTASIS; DECISION making; NOMOGRAPHY (Mathematics); CA 19-9 test; LYMPHADENECTOMY
- Publication
European Radiology, 2019, Vol 29, Issue 7, p3725
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-019-06142-7