基于直肠腔内超声的影像组学模型预测直肠癌KRAS基因突变的应用
The application of radiomics models based on endorectal ultrasound images in predicting KRAS gene mutation in rectal cancer
甘雅娇 1胡淇平 2卓敏玲 1钱清富 1郭晶晶 1陈志奎1
作者信息
- 1. 福建医科大学附属协和医院超声科,福建福州 350001
- 2. 福建省福州市晋安区宦溪卫生院超声科,福建福州 350024
- 折叠
摘要
目的:探讨基于直肠腔内超声(endorectal ultrasound,ERUS)图像的影像组学模型对直肠癌患者KRAS基因突变的预测价值.方法:本研究共纳入225例就诊于福建医科大学附属协和医院的直肠癌患者,按17∶3随机将患者分为训练组(191例)和测试组(34例).选择每例患者的清晰且肿瘤浸润最深的ERUS图像,进行手动分割和特征提取,经过降维和筛选后,分别采用logistic回归(logistic regression,LR)、支持向量机(support vector machine,SVM)、随机森林(random forest,RF)3种算法构建模型.绘制受试者工作曲线、校准曲线和决策曲线分析(decision curve analysis,DCA),分别用于评估模型的预测效能、拟合优度和临床价值,并通过DeLong检验比较3个模型的效能差异.结果:经筛选后得到了8个最佳的影像组学特征,训练组和测试组中SVM、LR和RF的曲线下面积(area under curve,AUC)分别为0.94、0.93、0.91和0.82、0.88、0.85.经DeLong检验,3个模型的AUC差异无统计学意义(均P＞0.05).DCA结果显示,3个模型均具有一定的临床效益,其中测试组LR模型的临床效益最高.校准曲线显示3个模型均有良好的拟合效果.结论:ERUS图像的影像组学模型对直肠癌KRAS基因突变有良好的预测价值,可作为无创预测直肠癌患者KRAS基因突变的补充方法,有助于指导临床决策.
Abstract
Objective:To explore the predictive value of radiomics models based on endorectal ultrasound(ERUS)images for KRAS gene mutations in rectal cancer patients.Methods:A total of 225 patients with rectal cancer admitted to Fujian Medical University Union Hospital were included in this study.Those patients were randomly separated into training cohort(191 cases)and testing cohort(34 cases)according to the ratio of 17∶3.The ERUS images of each patient's clearest and deepest tumor infiltration section were selected for manual segmentation and feature extraction.After dimensionality reduction and selection,three classification algorithms,logistic regression(LR),support vector machine(SVM)and random forest(RF)were used to construct models to predict the KRAS gene status of rectal cancer.Receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were drawn to evaluated the predictive performance,goodness of fit and clinical value of the models,respectively.DeLong test was used to compare the efficiency differences of the three models.Results:After features selection,the best 8 features were used to construct models for predicting KRAS gene mutations in rectal cancer patients.The area under the curve(AUC)of SVM,LR and RF models were 0.94,0.93,0.91 and 0.82,0.88,0.85 in the training cohort and testing cohort,respectively.There was no significant difference in the AUC of the three models(all P＞0.05)by DeLong test.The DCA showed that all three models had certain clinical benefits,and the LR model had the highest clinical benefit in the testing cohort.The calibration curve showed that the three models fitted well.Conclusion:The radiomics models of ERUS images have great predictive value for KRAS gene mutations in rectal cancer.It can be used as a supplementary method for non-invasive evaluation of KRAS gene mutations in rectal cancer patients and has great guiding significance for clinical selection of targeted therapy.
关键词
直肠癌/直肠腔内超声/KRAS基因/影像组学Key words
Rectal cancer/Endorectal ultrasound/KRAS gene/Radiomics引用本文复制引用
出版年
2024
NETL
NSTL
万方数据