| Literature DB >> 34646763 |
Mei-Qing Cheng1, Meng-Fei Xian1, Wen-Shuo Tian1, Ming-De Li1, Hang-Tong Hu1, Wei Li1, Jian-Chao Zhang1, Yang Huang1, Xiao-Yan Xie1, Ming-De Lu1,2, Ming Kuang1,2, Wei Wang1, Si-Min Ruan1, Li-Da Chen1.
Abstract
OBJECTIVE: To explore a new method for color image analysis of ultrasomics and investigate the efficiency in differentiating focal liver lesions (FLLs) by Red, Green, and Blue (RGB) three-channel SWE-based ultrasomics model.Entities:
Keywords: elasticity imaging techniques; liver; machine learning; radiomics; ultrasonography
Year: 2021 PMID: 34646763 PMCID: PMC8504873 DOI: 10.3389/fonc.2021.704218
Source DB: PubMed Journal: Front Oncol ISSN: 2234-943X Impact factor: 6.244
Figure 1Inclusion flow chart for the study population.
Figure 2RGB image decomposition by the RGB three-channel method. A 56-year-old man with a 3.5-cm HCC in segment 2 of the liver. The depth from the body surface to the center of the lesion was <8 cm. (A) SWE color-code image. (B) Red channel. (C) Green channel. (D) Blue channel.
Clinical–pathological characteristics and ultrasomics score in the training and validation cohorts.
| Training cohort | Validation cohort |
| |
|---|---|---|---|
|
| |||
| Gender (male/female) | 45/19 | 45/18 | 1.000 |
| Age (mean ± SD)* | 51.3 ± 13.8 | 47.0 ± 13.8 | 0.077 |
| Hepatitis (positive/negative) | 29/35 | 33/30 | 0.480 |
| AFP (<20/≥20) (ng/ml) | 43/21 | 42/21 | 1.000 |
|
| |||
| Lesion size (mean ± SD) * (cm) | 5.3 ± 3.2 | 5.6 ± 3.2 | 0.520 |
| Pathology (benign/malignant) | 20/45 | 20/45 | 1.000 |
| Benign | |||
| Hemangiomas | 15/20 | 12/20 | 0.501 |
| FNH | 2/20 | 6/20 | 0.235 |
| Inflammatory pseudotumor | 3/20 | 2/20 | 1.000 |
| Malignant | |||
| HCC | 31/45 | 30/45 | 1.000 |
| ICC | 6/45 | 6/45 | 1.000 |
| MLC | 8/45 | 9/45 | 1.000 |
| Ultrasomics score* | |||
| Direct score | 0.66 ± 0.40 | 0.64 ± 0.23 | 0.686 |
| RGB score | 0.68 ± 0.41 | 0.63 ± 0.32 | 0.452 |
Unless otherwise indicated, data are numbers.
*Data are mean ± standard deviation.
AFP, alpha-fetoprotein; RGB, red, green and blue; FNH, focal nodular hyperplasia; HCC, hepatocellular carcinoma; ICC, intrahepatic cholangiocarcinoma; MLC, metastatic liver cancer.
Direct score refers to the application of direct conversion method to the image of the cases in the training and validation sets, and obtain the risks core of each case. RGB score refers to the application of RGB three-channel conversion method to the image of the cases in the training and validation sets, and obtain the risks core of each case.
Diagnostic performance of direct model and RGB model among different classifiers in the validation cohort.
| Model | Cutoff value† | Sensitivity | Specificity | Accuracy | PPV | NPV | |
|---|---|---|---|---|---|---|---|
| (95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |||
|
|
| 0.500 | 0.867 | 0.600 | 0.785 | 0.830 | 0.667 |
| (0.732, 0.949) | (0.361, 0.809) | (0.584, 1.032) | (0.738, 0.894) | (0.467, 0.820) | |||
|
| 0.450 | 0.933 | 0.850 | 0.908 | 0.933 | 0.850 | |
| (0.817, 0.986) | (0.621, 0.978) | (0.691, 1.171) | (0.831, 0.976) | (0.652, 0.945) | |||
|
|
| 0.701 | 0.822 | 0.500 | 0.723 | 0.787 | 0.556 |
| (0.679, 0.920) | (0.272, 0.728) | (0.531, 0.962) | (0.700, 0.854) | (0.368, 0.729) | |||
|
| 0.661 | 0.756 | 0.850 | 0.785 | 0.919 | 0.607 | |
| (0.605, 0.871) | (0.621, 0.968) | (0.584, 1.032) | (0.798, 0.970) | (0.472, 0.727) | |||
|
|
| 0.585 | 0.578 | 0.800 | 0.646 | 0.867 | 0.457 |
| (0.422, 0.723) | (0.563, 0.943) | (0.466, 0.873) | (0.723, 0.942) | (0.359, 0.558) | |||
|
| 0.531 | 0.800 | 0.850 | 0.815 | 0.923 | 0.654 | |
| (0.654, 0.904) | (0.621, 0.968) | (0.611, 1.067) | (0.807, 0.972) | (0.506, 0.777) | |||
|
|
| 0.273 | 0.822 | 0.450 | 0.708 | 0.771 | 0.529 |
| (0.679, 0.920) | (0.231, 0.685) | (0.518, 0.944) | (0.689, 0.836) | (0.337, 0.713) | |||
|
| 0.686 | 0.711 | 0.900 | 0.769 | 0.941 | 0.581 | |
| (0.557, 0.836) | (0.683, 0.988) | (0.571, 1.014) | (0.809, 0.984) | (0.461, 0.691) |
Unless otherwise indicated, data are percentages, and data in parentheses are 95% confidence intervals.
†Data are cutoff risk score (the output is the specific value, 0–1).
CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value; RGB, red, green, and blue; RF, random forest; SVM, support vector machine; AdaBoost, adaptive boosting; LR logistic regression.
Direct model refers to the model construction based on the application of direct conversion method to the image of the cases in validation set. RGB model refers to the model construction based on the application of RGB three-channel conversion method to the image of the cases in the validation set.
Figure 3Receiver operating characteristic (ROC) curves for the direct model and RGB model were performed in the validation cohort. The area under the curve for direct model US and RGB model were 0.813 (95% CI, 0.697–0.899) and 0.926 (95% CI, 0.833–0.976), respectively.
Evaluation the performance of direct model and RGB model of the validation cohort.
| Models | AUC | NRI | |||||
|---|---|---|---|---|---|---|---|
| AUC (95% CI) |
| NRI+ | NRI− | NRI |
| ||
|
|
| 0.813 (0.697, 0.899) |
| – | – | – |
|
|
| 0.926 (0.833, 0.976) | 0.067 | 0.250 | 0.317 | |||
|
|
| 0.660 (0.532, 0.773) |
| – | – | – |
|
|
| 0.857 (0.748, 0.931) | −0.067 | 0.350 | 0.283 | |||
|
|
| 0.679 (0.551, 0.789) |
| – | – | – |
|
|
| 0864 (0.757, 0.937) | 0.222 | 0.050 | 0.272 | |||
|
|
| 0.571 (0.442, 0.693) |
| – | – | – |
|
|
| 0.870 (0.763, 0.941) | −0.111 | 0.450 | 0.339 | |||
Data are percentages and data in parentheses are 95% confidence intervals.
AUC, area under the curve; CI, confidence interval; RF, random forest; SVM, support vector machine; AdaBoost adaptive boosting; LR, logistic regression; NRI+, movement in predicted risks introduced by change of models in malignant cases; NRI−, movement in predicted risks introduced by changes of model in benign cases.
Direct model refers to the model construction based on the application of direct conversion method to the image of the cases in validation set. RGB model refers to the model construction based on the application of RGB three-channel conversion method to the image of the cases in the validation set.
Figure 4Calibration curves for (A) direct model and (B) RGB model performed in the validation cohort. The calibration curves demonstrated a statistical goodness-of-fit measurement of the models in the characterization of focal liver lesions. The solid line represented the performance of the models, and the dotted line represented an ideal model. The lesser the solid line deviated from the dotted line, the better the calibration of the model.
Figure 5Decision curves for the direct model and RGB model were performed in the validation cohort.