Xinming Li1, Zhendong Qi1, Haiyan Du2, Zhijun Geng3, Zhipeng Li3, Shuping Qin1, Xuhui Zhang1, Jianye Liang3, Xiao Zhang2, Wen Liang1, Wei Yang2, Chuanmiao Xie4, Xianyue Quan5. 1. Department of Radiology, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Road, Guangzhou, People's Republic of China. 2. School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, People's Republic of China. 3. Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, People's Republic of China. 4. Department of Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, People's Republic of China. xiechm@sysucc.org.cn. 5. Department of Radiology, Zhujiang Hospital, Southern Medical University, No. 253, Industrial Road, Guangzhou, People's Republic of China. quanxianyue2014@163.com.
Abstract
OBJECTIVES: We aimed to develop and validate a deep convolutional neural network (DCNN) model for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) and its clinical outcomes using contrast-enhanced computed tomography (CECT) in a large population of candidates for surgery. METHODS: This retrospective study included 1116 patients with HCC who had undergone preoperative CECT and curative hepatectomy. Radiological (R), DCNN, and combined nomograms were constructed in a training cohort (n = 892) respectively based on clinicoradiological factors, DCNN probabilities, and all factors; the performance of each model was confirmed in a validation cohort (n = 244). Accuracy and the AUC to predict MVI were calculated. Disease-free survival (DFS) and overall survival (OS) after surgery were recorded. RESULTS: The proportion of MVI-positive patients was respectively 38.8% (346/892) and 35.7 % (87/244) in the training and validation cohorts. The AUCs of the R, DCNN, and combined nomograms were respectively 0.809, 0.929, and 0.940 in the training cohorts and 0.837, 0.865, and 0.897 in the validation cohort. The combined nomogram outperformed the R nomogram in the training (p < 0.001) and validation (p = 0.009) cohorts. There was a significant difference in DFS and OS between the R, DCNN, and combined nomogram-predicted groups with and without MVI (p < 0.001). CONCLUSIONS: The combined nomogram based on preoperative CECT performs well for preoperative prediction of MVI and outcome. KEY POINTS: • A combined nomogram based on clinical information, preoperative CECT, and DCNN can predict MVI and clinical outcomes of patients with HCC. • DCNN provides added diagnostic ability to predict MVI. • The AUCs of the combined nomogram are 0.940 and 0.897 in the training and validation cohorts, respectively.
OBJECTIVES: We aimed to develop and validate a deep convolutional neural network (DCNN) model for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) and its clinical outcomes using contrast-enhanced computed tomography (CECT) in a large population of candidates for surgery. METHODS: This retrospective study included 1116 patients with HCC who had undergone preoperative CECT and curative hepatectomy. Radiological (R), DCNN, and combined nomograms were constructed in a training cohort (n = 892) respectively based on clinicoradiological factors, DCNN probabilities, and all factors; the performance of each model was confirmed in a validation cohort (n = 244). Accuracy and the AUC to predict MVI were calculated. Disease-free survival (DFS) and overall survival (OS) after surgery were recorded. RESULTS: The proportion of MVI-positive patients was respectively 38.8% (346/892) and 35.7 % (87/244) in the training and validation cohorts. The AUCs of the R, DCNN, and combined nomograms were respectively 0.809, 0.929, and 0.940 in the training cohorts and 0.837, 0.865, and 0.897 in the validation cohort. The combined nomogram outperformed the R nomogram in the training (p < 0.001) and validation (p = 0.009) cohorts. There was a significant difference in DFS and OS between the R, DCNN, and combined nomogram-predicted groups with and without MVI (p < 0.001). CONCLUSIONS: The combined nomogram based on preoperative CECT performs well for preoperative prediction of MVI and outcome. KEY POINTS: • A combined nomogram based on clinical information, preoperative CECT, and DCNN can predict MVI and clinical outcomes of patients with HCC. • DCNN provides added diagnostic ability to predict MVI. • The AUCs of the combined nomogram are 0.940 and 0.897 in the training and validation cohorts, respectively.
Authors: Wenya Linda Bi; Ahmed Hosny; Matthew B Schabath; Maryellen L Giger; Nicolai J Birkbak; Alireza Mehrtash; Tavis Allison; Omar Arnaout; Christopher Abbosh; Ian F Dunn; Raymond H Mak; Rulla M Tamimi; Clare M Tempany; Charles Swanton; Udo Hoffmann; Lawrence H Schwartz; Robert J Gillies; Raymond Y Huang; Hugo J W L Aerts Journal: CA Cancer J Clin Date: 2019-02-05 Impact factor: 508.702