目的:我们旨在比较三种不同的影像组学模型的性能(逻辑回归(LR),随机森林(RF),和支持向量机(SVM))和临床列线图(Briganti,MSKCC,耶鲁,和Roach)用于预测前列腺癌(PCa)患者的淋巴结受累(LNI)。
方法:回顾性研究包括95例接受了mp-MRI和根治性前列腺切除术并进行盆腔淋巴结清扫的患者。成像数据(T2中的强度,DWI,ADC,andPIRADS),临床数据(年龄和MRI前PSA),组织学数据(格里森评分,TNM分期,组织学类型,胶囊侵入,精囊侵入,和神经血管束受累),和临床列线图(耶鲁,罗奇,MSKCC,和Briganti)为每位患者收集。使用开源程序(3DSLICER)对每位患者进行索引病变的手动分割。使用Pyradiomics文库为每个序列(T2,DWI,和ADC)。然后选择这些特征,并用于训练和测试三种不同的影像组学模型(LR,射频,和SVM)独立使用ChatGPT软件(v4o)。计算每个特征的系数值(系数的显著值≥±0.5)。使用准确性和曲线下面积(AUC)(p≤0.05的显著性值)评估影像组学模型和临床列线图的预测性能。因此,比较了影像组学和临床模型之间的诊断准确性.
结果:本研究确定每位患者343个特征(330个影像组学特征和13个临床特征)。最显着的特征是T2_nodulofirstordervariance和T2_nodulofirstorderkosis。具有DWI的RF模型实现了最高的预测性能(准确率86%,AUC0.89)和ADC(精度89%,AUC0.67)。与DWI序列中的RF模型相比,临床列线图显示出令人满意但较低的预测性能。
结论:在使用集成数据(影像组学和语义)开发的预测模型中,与PCa淋巴结受累预测中的临床列线图相比,RF在AUC方面显示出略高的诊断准确性。
OBJECTIVE: We aim to compare the performance of three different radiomics models (logistic regression (LR), random forest (RF), and support vector machine (SVM)) and clinical nomograms (Briganti, MSKCC, Yale, and Roach) for predicting lymph node involvement (LNI) in prostate cancer (PCa) patients.
METHODS: The retrospective study includes 95 patients who underwent mp-MRI and radical prostatectomy for PCa with pelvic lymphadenectomy. Imaging data (intensity in T2, DWI, ADC, and PIRADS), clinical data (age and pre-MRI PSA), histological data (Gleason score, TNM staging, histological type, capsule invasion, seminal vesicle invasion, and neurovascular bundle involvement), and clinical nomograms (Yale, Roach, MSKCC, and Briganti) were collected for each patient. Manual segmentation of the index lesions was performed for each patient using an open-source program (3D SLICER). Radiomic features were extracted for each segmentation using the Pyradiomics library for each sequence (T2, DWI, and ADC). The features were then selected and used to train and test three different radiomics models (LR, RF, and SVM) independently using ChatGPT software (v 4o). The coefficient value of each feature was calculated (significant value for coefficient ≥ ±0.5). The predictive performance of the radiomics models and clinical nomograms was assessed using accuracy and area under the curve (AUC) (significant value for p ≤ 0.05). Thus, the diagnostic accuracy between the radiomics and clinical models were compared.
RESULTS: This study identified 343 features per patient (330 radiomics features and 13 clinical features). The most significant features were T2_nodulofirstordervariance and T2_nodulofirstorderkurtosis. The highest predictive performance was achieved by the RF model with DWI (accuracy 86%, AUC 0.89) and ADC (accuracy 89%, AUC 0.67). Clinical nomograms demonstrated satisfactory but lower predictive performance compared to the RF model in the DWI sequences.
CONCLUSIONS: Among the prediction models developed using integrated data (radiomics and semantics), RF shows slightly higher diagnostic accuracy in terms of AUC compared to clinical nomograms in PCa lymph node involvement prediction.