Accurate and Feasible Deep Learning Based Semi-automatic Segmentation in CT for Radiomics Analysis in Pancreatic Neuroendocrine Neoplasms.

Current clinical practice or radiomics studies of pancreatic neuroendocrine neoplasms (pNENs) require manual delineation of the lesions in computed tomography (CT) images, which is time-consuming and subjective. We used a semi-automatic deep learning (DL) method for segmentation of pNENs and verified its feasibility in radiomics analysis. This retrospective study included two datasets: Dataset 1, contrast-enhanced CT images (CECT) of 80 and 18 patients respectively collected from two centers; and Dataset 2, CECT of 56 and 16 patients respectively from two centers. A DL-based semi-automatic segmentation model was developed and validated with Dataset 1 and Dataset 2, and the segmentation results were used for radiomics analysis from which the performance was compared against that based on manual segmentation. The mean Dice similarity coefficient of the trained segmentation model was 81.8% and 74.8% for external validation with Dataset 1 and Dataset 2 respectively. Four classifiers frequently used in radiomics studies were trained and tested with leave-one-out cross-validation strategy. For pathological grading prediction with Dataset 1, the area under the receiver operating characteristic curve (AUC) with semi-automatic segmentation was up to 0.76 and 0.87 respectively for internal and external validation. For recurrence study with Dataset 2, the AUC with semi-automatic segmentation was up to 0.78. All these AUCs were not statistically significant from the corresponding results based on manual segmentation. Our study showed that DL-based semi-automatic segmentation is accurate and feasible for the radiomics analysis in pNENs.