Yunming Xie1, Hongguang Zhao2, Yan Guo3, Fanyang Meng1, Xiangchun Liu1, Yiying Zhang1, Xiaochen Huai4, Qianting Wong2, Yu Fu5, Huimao Zhang6. 1. Department of Radiology, The First Hospital of Jilin University, No.71 Xinmin Street, Changchun, 130012, Jilin, China. 2. Department of Nuclear Medicine, The First Hospital of Jilin University, Changchun, Jilin, China. 3. GE Healthcare, Shanghai, China. 4. Philips Healthcare, Beijing, China. 5. Department of Radiology, The First Hospital of Jilin University, No.71 Xinmin Street, Changchun, 130012, Jilin, China. fuyu-1985@163.com. 6. Department of Radiology, The First Hospital of Jilin University, No.71 Xinmin Street, Changchun, 130012, Jilin, China. huimaozhanglinda@163.com.
Abstract
OBJECTIVES: To develop and validate a PET/CT nomogram for preoperative estimation of lymph node (LN) staging in patients with non-small cell lung cancer (NSCLC). METHODS: A total of 263 pathologically confirmed LNs from 124 patients with NCSLC were retrospectively analyzed. Positron-emission tomography/computed tomography (PET/CT) examination was performed before treatment according to the clinical schedule. In the training cohort (N = 185), malignancy-related features, such as SUVmax, short-axis diameter (SAD), and CT radiomics features, were extracted from the regions of LN based on the PET/CT scan. The Minimum-Redundancy Maximum-Relevance (mRMR) algorithm and the Least Absolute Shrinkage and Selection Operator (LASSO) regression model were used for feature selection and radiomics score building. The radiomics score (Rad-Score) and SUVmax were incorporated in a PET/CT nomogram using the multivariable logistic regression analysis. The performance of the proposed model was evaluated with discrimination, calibration, and clinical application in an independent testing cohort (N = 78). RESULTS: The radiomics scores consisting of 14 selected features were significantly associated with LN status for both training cohort with AUC of 0.849 (95% confidence interval (CI), 0.796-0.903) and testing cohort with AUC of 0.828 (95% CI, 0.782-0.919). The PET/CT nomogram incorporating radiomics score and SUVmax showed moderate improvement of the efficiency with AUC of 0.881 (95% CI, 0.834-0.928) in the training cohort and AUC of 0.872 (95% CI, 0.797-0.946) in the testing cohort. The decision curve analysis indicated that the PET/CT nomogram was clinically useful. CONCLUSION: The PET/CT nomogram, which incorporates Rad-Score and SUVmax, can improve the diagnostic performance of LN metastasis. KEY POINTS: • The PET/CT nomogram (Int-Score) based on lymph node (LN) PET/CT images can reliably predict LN status in NSCLC. • Int-Score is a relatively objective diagnostic method, which can play an auxiliary role in the process of clinicians making treatment decisions.
OBJECTIVES: To develop and validate a PET/CT nomogram for preoperative estimation of lymph node (LN) staging in patients with non-small cell lung cancer (NSCLC). METHODS: A total of 263 pathologically confirmed LNs from 124 patients with NCSLC were retrospectively analyzed. Positron-emission tomography/computed tomography (PET/CT) examination was performed before treatment according to the clinical schedule. In the training cohort (N = 185), malignancy-related features, such as SUVmax, short-axis diameter (SAD), and CT radiomics features, were extracted from the regions of LN based on the PET/CT scan. The Minimum-Redundancy Maximum-Relevance (mRMR) algorithm and the Least Absolute Shrinkage and Selection Operator (LASSO) regression model were used for feature selection and radiomics score building. The radiomics score (Rad-Score) and SUVmax were incorporated in a PET/CT nomogram using the multivariable logistic regression analysis. The performance of the proposed model was evaluated with discrimination, calibration, and clinical application in an independent testing cohort (N = 78). RESULTS: The radiomics scores consisting of 14 selected features were significantly associated with LN status for both training cohort with AUC of 0.849 (95% confidence interval (CI), 0.796-0.903) and testing cohort with AUC of 0.828 (95% CI, 0.782-0.919). The PET/CT nomogram incorporating radiomics score and SUVmax showed moderate improvement of the efficiency with AUC of 0.881 (95% CI, 0.834-0.928) in the training cohort and AUC of 0.872 (95% CI, 0.797-0.946) in the testing cohort. The decision curve analysis indicated that the PET/CT nomogram was clinically useful. CONCLUSION: The PET/CT nomogram, which incorporates Rad-Score and SUVmax, can improve the diagnostic performance of LN metastasis. KEY POINTS: • The PET/CT nomogram (Int-Score) based on lymph node (LN) PET/CT images can reliably predict LN status in NSCLC. • Int-Score is a relatively objective diagnostic method, which can play an auxiliary role in the process of clinicians making treatment decisions.
Authors: Chunxiang Li; Ge Qiao; Jinghan Li; Lisha Qi; Xueqing Wei; Tan Zhang; Xing Li; Shu Deng; Xi Wei; Wenjuan Ma Journal: Front Oncol Date: 2022-03-04 Impact factor: 6.244