Contrast-enhanced CT radiomics combined with clinical and hematology indicators for diagnosing lymph node metastasis of esophageal squamous cell carcinoma
10.13929/j.issn.1003-3289.2024.11.011
- VernacularTitle:增强CT影像组学联合临床及血液学指标诊断食管鳞状细胞癌淋巴结转移
- Author:
Xinmiao YANG
1
;
Changhua LIANG
;
Qingxia WU
;
Ben PAN
;
Hanyu WEI
;
Siyu ZHEN
;
Ziqing YANG
;
Huihui WANG
Author Information
1. 新乡医学院第一附属医院放射科,河南新乡 453100
- Keywords:
esophageal neoplasms;
lymphatic metastasis;
tomography,X-ray computed;
radiomics;
hematology
- From:
Chinese Journal of Medical Imaging Technology
2024;40(11):1682-1687
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the value of contrast-enhanced CT radiomics combined with clinical and hematology indicators for predicting lymph node(LN)metastasis(LNM)of esophageal squamous cell carcinoma(ESCC).Methods Totally 218 ESCC patients were retrospectively enrolled.Stage pN1 and pN2 were clustering as LNM(n=90),while stage pN0 were taken as non-LNM(n=128).The patients were divided into training set(n=174)and test set(n=44)at the ratio of 8∶2.In training set,clinical and LN imaging features which could be used to independently judge LNM were screened and a clinical-imaging model was constructed.The hematological indicators that might be associated with ESCC LNM were screened,and a hematological model was constructed.Radiomics features in LN ROI and ESCC volume of interest(VOI)were extracted based on venous-phase contrast-enhanced CT images,and those might be associated with LNM were screened,and a radiomics model was constructed.Finally a combined model was constructed based on all the above features.The efficacy of each model for diagnosing LNM was evaluated with the area under the curve(AUC)of receiver operating characteristic curves,and the clinical net benefit was evaluated using decision curve analysis(DCA).Results Body mass index(BMI)and internal necrosis of target LN were both independent judging factors for ESCC LNM(both P＜0.05),and AUC of clinical-imaging model for diagnosing LNM in training and test sets was 0.747 and 0.687,respectively.Seven hematological indicators were included in hematological model,and AUC in training and test sets was 0.623 and 0.583,respectively.Ten LN radiomics features and 15 ESCC radiomics features were included in radiomics model,and AUC in training and test sets was 0.769 and 0.745,respectively.AUC of the combined model for diagnosing LNM in training and test sets was 0.822 and 0.739,respectively,better than other models in training set(all P＜0.05),but no significantly different in test set(all P＞0.05).DCA showed that combined model had higher net gain than the other models in 0.55-0.80 threshold probability interval.Conclusion Combined model based on venous-phase contrast-enhanced CT radiomics and clinical and hematology indicators could relatively effectively evaluate ESCC LNM,which might bring some promotions in clinical benefit.
