背景:舌癌根治术的安全切缘是最重要的预后因素之一。然而,肿瘤周围组织在使用影像组学分析预测淋巴结转移(LNM)和预后中的作用尚不清楚.
目的:研究基于磁共振成像(MRI)的影像组学分析与肿瘤周围扩展是否有助于舌癌的LNM和预后预测。
方法:回顾性。
方法:患有舌癌的两百三十六例患者(38.56%为女性)(训练集,N=157;测试装置,N=79;女性分别为37.58%和40.51%)。
■1.5T;T2加权涡轮自旋回波图像。
结果:影像组学模型(Rprim,Rprim+3,Rprim+5,Rprim+10,Rprim+15)是用从原发肿瘤中提取的没有或有肿瘤周围延伸的特征(3、5、10和15mm,分别)。从单因素分析中选择的临床病理特征,包括MRI报告的LN状态,放射学外在舌肌侵入,和病理浸润深度(DOI)进一步纳入放射组学模型,以开发联合放射组学模型(CRprim,CRprim+3,CRprim+5,CRprim+10,CRprim+15)。最后,在测试集中对模型性能进行了验证。从邻近的正常粘膜到肿瘤浸润的最深点测量DOI。
■卡方检验,回归分析,接收器工作特性曲线(ROC)分析,决策分析,斯皮尔曼相关分析。Delong检验用于比较ROC下面积(AUC)。P<0.05被认为具有统计学意义。
结果:在所有模型中,CRprim+10在训练集中达到最高AUC,为0.995,在测试集中达到0.872.影像组学特征与病理DOI显著相关(相关系数,-0.157至-0.336)。CRprim+10是无病生存率低的独立指标(风险比,5.250)和总生存率(风险比,17.464)在测试集中。
■具有10毫米肿瘤周围延伸的Radiomics分析对于预测舌癌的LNM和预后具有出色的能力。
BACKGROUND: Adequate safe margin in tongue cancer radical surgery is one of the most important prognostic factors. However, the role of peritumoral tissues in predicting lymph node metastasis (LNM) and prognosis using radiomics analysis remains unclear.
OBJECTIVE: To investigate whether magnetic resonance imaging (MRI)-based radiomics analysis with peritumoral extensions contributes toward the prediction of LNM and prognosis in tongue cancer.
METHODS: Retrospective.
METHODS: Two hundred and thirty-six patients (38.56% female) with tongue cancer (training set, N = 157; testing set, N = 79; 37.58% and 40.51% female for each).
UNASSIGNED: 1.5 T; T2-weighted turbo spin-echo images.
RESULTS: Radiomics models (Rprim , Rprim+3 , Rprim+5 , Rprim+10 , Rprim+15 ) were developed with features extracted from the primary tumor without or with peritumoral extensions (3, 5, 10, and 15 mm, respectively). Clinicopathological characteristics selected from univariate analysis, including MRI-reported LN status, radiological extrinsic lingual muscle invasion, and pathological depth of invasion (DOI) were further incorporated into radiomics models to develop combined radiomics models (CRprim , CRprim+3 , CRprim+5 , CRprim+10 , CRprim+15 ). Finally, the model performance was validated in the testing set. DOI was measured from the adjacent normal mucosa to the deepest point of tumor invasion.
UNASSIGNED: Chi-square test, regression analysis, receiver operating characteristic curve (ROC) analysis, decision analysis, spearman correlation analysis. The Delong test was used to compare area under the ROC (AUC). P < 0.05 was considered statistically significant.
RESULTS: Of all the models, the CRprim+10 reached the highest AUC of 0.995 in the training set and 0.872 in the testing set. Radiomics features were significantly correlated with pathological DOI (correlation coefficients, -0.157 to -0.336). The CRprim+10 was an independent indicator for poor disease-free survival (hazard ratio, 5.250) and overall survival (hazard ratio, 17.464) in the testing set.
UNASSIGNED: Radiomics analysis with a 10-mm peritumoral extension had excellent power to predict LNM and prognosis in tongue cancer.