Differentiating adenocarcinoma in situ and microinvasive adenocarcinoma of lung based on intratumoral and peritumoral CT radiomics models combined with clinical and routine CT features
	    		
		   		
		   			
		   		
	    	
    	 
    	10.13929/j.issn.1003-3289.2024.06.015
   		
        
        	
        		- VernacularTitle:瘤内与瘤周CT影像组学模型结合临床及常规CT特征鉴别肺原位腺癌与微浸润性腺癌
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Jie SHEN
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Ye ZHANG
			        		
			        		;
		        		
		        		
		        		
			        		Xiaomei JIN
			        		
			        		;
		        		
		        		
		        		
			        		Jiejun KONG
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 南京医科大学附属脑科医院胸科院区放射科,江苏南京 210009
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		adenocarcinoma of lung;
			        		
			        		
			        		
				        		carcinoma in situ;
			        		
			        		
			        		
				        		tomography,X-ray computed;
			        		
			        		
			        		
				        		radiomics
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Medical Imaging Technology
	            		
	            		 2024;40(6):869-873
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Objective To observe the value of intratumoral and peritumoral radiomics models combined with clinical and routine CT features for differentiating adenocarcinoma in situ(AIS)and microinvasive adenocarcinoma(MIA)of lung.Methods Totally 180 patients with isolated AIS and 180 with isolated MIA were retrospectively included,among them 160 AIS cases and 160 MIA cases were randomly selected into training set(n=320),while the other 20 AIS cases and 20 MIA cases were selected into test set(n=40).In training set,clinical and conventional CT features being statistically different between AIS and MIA were obtained to construct clinical model.Besides,radiomics features were extracted from intratumoral(CTi)ROI,intra-and peritumoral 2 mm(CTi+p2mm)ROI and intra-and peritumoral 4 mm(CTi+p4mm)ROI,and then CTi model,CTi+p2mm model and CTi+p4mm model for differentiating MIA and AIS were constructed.The optimal radiomics model for predicting MIA was selected using the area under the curve(AUC)of receiver operating characteristic(ROC)curve,and a combined model was built based on the optimal radiomics model combining with clinical and conventional CT features.The AUC,calibration and net benefit of the clinical model,the optimal radiomics model and the combined model were assessed.Results In training set,the larger nodular diameter,higher percentage of inhomogeneous density and ratio of nodules with vascular signals were observed in MIA compared with those in AIS(all P<0.05).In test set,CTi+p2mm model had the highest efficacy(AUC=0.838)for differentiating MIA from AIS(P<0.05),and the combined model had better efficacy(AUC=0.867,P<0.05).The calibration of combined model was good,and the net benefit was high in 0.60-0.90 threshold probability range.Conclusion The radiomics model constructed with intratumoral and peritumoral 2 mm ROI based on plain CT was effective for differentiating MIA from AIS.Combining with clinical and routine CT features could furtherly improve differential diagnostic efficacy.