The Research of Application of Predicting MSI in Colorectal Cancer Based on Spectral CT Radiomics
Objective To study the radiomics model based on single energy sequence of spectral CT imaging in ve-nous phase for predicting microsatellite instability(MSI)status of colorectal cancer.Methods From July 2019 to August 2022,97 patients(57 males and 40 females)with colorectal cancer diagnosed by surgical resection or biop-sy in Taizhou People's Hospital were retrospectively collected.According to the results of immunohistochemical MSI expression,the patients were divided into MSI group(34 cases)and MSS group(63 cases).The raw image data of 1.25 mm venous images were transmitted to GE AW4.7 post-processing workstation in DICOM format to generate iodine-based material decomposition maps,70keV,100keV monoenergetic maps.The images were imported into ITK-SNAP open source software,and the region of interest(ROI)was manually delineated.The radiomics feature extraction was performed using the Pyradiomics tool.The mRMR(maximum relevance and minimum redundancy)and LASSO(least absolute shrinkage and selection operator)algorithms were used to re-duce the dimension of the radiomics features of the training group and obtain the key radiomics features,and the radiomics model for predicting tumor biological behavior was established.The area under the ROC curve(AUC)analysis was used to evaluate the diagnostic efficacy of the ten models.The calibration curve was used to evaluate the calibration performance of the model,and the decision curve was used to evaluate the clinical practi-cability of the model in the training group.Results Venous phase single energy 70keV,100keV sequence,io-dine-based material decomposition diagram,sequence diagram extracted 1218 features respectively,among which the venous phase 70 keV single energy sequence had the best classification performance.Conclusion The single-energy model based on energy spectrum CT imaging can distinguish MSI status from MSS status effective-ly,It can be used as an important imaging biomarker to predict the status of MSI in colorectal cancer patients be-fore operation,and provide a new way to guide clinician to make individualized treatment plan and evaluate the prognosis of patients.
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