首页|定位CT影像组学联合患侧肺剂量学参数对乳腺癌放疗患者放射性肺炎发生的预测价值

定位CT影像组学联合患侧肺剂量学参数对乳腺癌放疗患者放射性肺炎发生的预测价值

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目的 探讨基于机器学习算法的放射性肺炎(RP)预测模型的构建及价值。方法 回顾性分析2019年8月至2022年9月于该院接受放疗并定期随访的77例乳腺癌患者的临床资料。在定位CT上勾画患侧肺作为感兴趣区域并提取影像组学特征,同时提取患侧肺剂量学参数。经过特征筛选后,将患者按7∶3分为训练集和测试集,提取定位CT影像组学特征并联合患侧肺剂量学参数,使用随机梯度下降(SGD)算法建立模型,采用受试者工作特征(ROC)曲线的曲线下面积(AUC)和决策曲线分析(DCA)验证模型效能。结果 77例患者中24例在放疗结束后6个月内发生RP,发生率为31。17%。与未发生RP比较,发生RP患者的患侧肺V5、V10、V15、V20、V25、V3。和平均肺剂量(MLD)更高,差异有统计学意义(P<0。05)。训练集中36例未发生RP、17例发生RP,测试集中17例未发生RP、7例发生RP。发生RP与未发生RP的训练集、测试集患侧肺剂量参数比较,差异无统计学意义(P>0。05)。经过特征筛选,最终得到8个最优特征组合。SGD模型在训练集五折交叉验证的平均AUC为0。900,测试集AUC为0。882。结论 定位CT影像组学特征联合患侧肺剂量学参数对乳腺癌放疗后RP具有良好的预测价值。
Predictive value of positioning CT radiomics combined with affected side lung dosimetry parameters for radiation pneumonitis occurrence in patients with breast cancer radiotherapy
Objective To investigate the construction and value of radiation pneumonitis(RP)predic-tive model based on machine learning algorithm.Methods A retrospective analysis was conducted on the clin-ical data in 77 patients with breast cancer receiving radiotherapy and regular follow-up in this hospital from August 2019 to September 2022.The affected side lung was delineated on the localization CT as the area of in-terest and the radiomics features were extracted,meanwhile the affected side lung dosimetric parameters were extracted.After feature screening,the patients were divided into the training set and testing set by a 7∶3 rati-o.The features of positioning CT radiomics were extracted and combined with the dosimetry parameters of the affected side lung,and the model was established by using stochastic gradient descent(SGD)algorithm.The performance of the model was validated by using the area under the receiver operating characteristic(ROC)curve(AUC)and decision curve analysis(DCA).Results Among 77 patients,24 cases developed RP after ra-diotherapy end with an incidence rate of 31.17%.Compared with the patients without RP occurrence,V5,V10,V15,V20,V25,V30 and mean lung dose(MLD)in the patients with RP occurrence were higher,and the differ-ence was statistically significant(P<0.05).In the training set,36 cases did not develop RP.17 cases devel-oped RP,in the testing set,17 cases did not develop RP and 7 cases developed RP.The affected side lung dosi-metric parameters had no statistical difference between the training set and testing set with and without RP occurrence(P>0.05).After characteristics screening,the 8 optimal characteristics combinations were finally obtained.The average AUC of SGD model in 50%off cross-validation of the training set was 0.900 and AUC in the test set was 0.882.Conclusion The positioning CT radiomics features combined with dosimetry param-eters of the affected side lung has the good predictive value for RP after breast cancer radiotherapy.

breast cancerradiotherapyradiation pneumonitisradiomicsprediction models

高彩云、梅长文、宫尚明、王丽丽、王玮

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宣城市人民医院医学影像科,安徽宣城 242000

宣城市人民医院放疗科,安徽宣城 242000

乳腺癌 放射治疗 放射性肺炎 影像组学 预测模型

安徽省宣城市卫生健康科研项目

XCWJ2022070

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(12)
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