Guangjie Yang1, Pei Nie2, Lianzi Zhao3, Jian Guo2, Wei Xue1, Lei Yan1, Jingjing Cui4, Zhenguang Wang5. 1. Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. 2. Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. 3. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. 4. Huiying Medical Technology Co. Ltd, Beijing, China. 5. Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. Electronic address: doctorwzg2002@hotmail.com.
Abstract
PURPOSE: Lymphovascular invasion (LVI) impairs surgical outcomes in lung adenocarcinoma (LAC) patients. Preoperative prediction of LVI is challenging by using traditional clinical and imaging factors. The purpose of this study was to evaluate the value of two-dimensional (2D) and three-dimensional (3D) CT texture analysis (CTTA) in predicting LVI in LAC. METHODS: A total of 149 LAC patients (50 LVI-present LACs and 99 LVI-absent LACs) were retrospectively enrolled. Clinical data and CT findings were analyzed to select independent clinical predictors. Texture features were extracted from 2D and 3D regions of interest (ROI) in 1.25 mm slice CT images. The 2D and 3D CTTA signatures were constructed with the least absolute shrinkage and selection operator algorithm and texture scores were calculated. The optimized CTTA signature was selected by comparing the predicting efficacy and clinical usefulness of 2D and 3D CTTA signatures. A CTTA nomogram was developed by integrating the optimized CTTA signature and clinical predictors, and its calibration, discrimination and clinical usefulness were evaluated. RESULTS: Maximum diametre and spiculation were independent clinical predictors. 1125 texture features were extracted from 2D and 3D ROIs and reduced to 11 features to build 2D and 3D CTTA signatures. There was significant difference (P < 0.001) in AUC (area under the curve) between 2D signature (AUC, 0.938) and 3D signature (AUC, 0.753) in the training set. There was no significant difference (P = 0.056) in AUC between 2D signature (AUC, 0.856) and 3D signature (AUC, 0.701) in the test set. Decision curve analysis showed the 2D signature outperformed the 3D signature in terms of clinical usefulness. The 2D CTTA nomogram (AUC, 0.938 and 0.861, in the training and test sets), which incorporated the 2D signature and clinical predictors, showed a similar discrimination capability (P = 1.000 and 0.430, in the training and test sets) and clinical usefulness as the 2D signature, and outperformed the clinical model (AUC, 0.678 and 0.776, in the training and test sets). CONCLUSIONS: 2D CTTA signature performs better than 3D CTTA signature. The 2D CTTA nomogram with the 2D signature and clinical predictors incorporated provides the similar performance as the 2D signature for individual LVI prediction in LAC.
PURPOSE: Lymphovascular invasion (LVI) impairs surgical outcomes in lung adenocarcinoma (LAC) patients. Preoperative prediction of LVI is challenging by using traditional clinical and imaging factors. The purpose of this study was to evaluate the value of two-dimensional (2D) and three-dimensional (3D) CT texture analysis (CTTA) in predicting LVI in LAC. METHODS: A total of 149 LAC patients (50 LVI-present LACs and 99 LVI-absent LACs) were retrospectively enrolled. Clinical data and CT findings were analyzed to select independent clinical predictors. Texture features were extracted from 2D and 3D regions of interest (ROI) in 1.25 mm slice CT images. The 2D and 3D CTTA signatures were constructed with the least absolute shrinkage and selection operator algorithm and texture scores were calculated. The optimized CTTA signature was selected by comparing the predicting efficacy and clinical usefulness of 2D and 3D CTTA signatures. A CTTA nomogram was developed by integrating the optimized CTTA signature and clinical predictors, and its calibration, discrimination and clinical usefulness were evaluated. RESULTS: Maximum diametre and spiculation were independent clinical predictors. 1125 texture features were extracted from 2D and 3D ROIs and reduced to 11 features to build 2D and 3D CTTA signatures. There was significant difference (P < 0.001) in AUC (area under the curve) between 2D signature (AUC, 0.938) and 3D signature (AUC, 0.753) in the training set. There was no significant difference (P = 0.056) in AUC between 2D signature (AUC, 0.856) and 3D signature (AUC, 0.701) in the test set. Decision curve analysis showed the 2D signature outperformed the 3D signature in terms of clinical usefulness. The 2D CTTA nomogram (AUC, 0.938 and 0.861, in the training and test sets), which incorporated the 2D signature and clinical predictors, showed a similar discrimination capability (P = 1.000 and 0.430, in the training and test sets) and clinical usefulness as the 2D signature, and outperformed the clinical model (AUC, 0.678 and 0.776, in the training and test sets). CONCLUSIONS: 2D CTTA signature performs better than 3D CTTA signature. The 2D CTTA nomogram with the 2D signature and clinical predictors incorporated provides the similar performance as the 2D signature for individual LVI prediction in LAC.
Authors: Arthur Jochems; Turkey Refaee; Henry C Woodruff; Philippe Lambin; Guangyao Wu; Abdalla Ibrahim; Chenggong Yan; Sebastian Sanduleanu Journal: Eur J Nucl Med Mol Imaging Date: 2021-03-11 Impact factor: 10.057