Predicting the risk of brain metastasis in non-small cell lung cancer patients after neoadjuvant chemotherapy based on CECT radiomics
Objective:To construct a nomogram for predicting brain metastases in non-small cell lung cancer(NSCLC)patients after neoadjuvant chemotherapy based on contrast-enhanced computed tomography(CECT)radiomics.Methods:252 NSCLC patients undergone neoadjuvant chemotherapy in our hospital between March 2018 and September 2021 were included in the model group,and another 110 patients visited out Shuyang Hospital affiliated to Xuzhou Medical University between October 2021 and July 2022 were included in the validation group.Logistic regression analysis was used to screen the risk factors for brain metastases in NSCLC patients after neoadjuvant chemotherapy.LIFEx software was used to extract radiomics features from CECT images of NSCLC patients before neoadjuvant chemotherapy,and LASSO was used to screen the parameters of CECT quantitative imaging indicators.Models were established based on CECT radiomics and clinical features.By integrating optimized CECT radiomics and clinical feature models,a nomogram for brain metastasis in NSCLC patients after neoadjuvant chemotherapy was established using R software.Results:Logistic regression analysis showed that stage IV NSCLC,adenocarcinoma,low differentiation and lymph node metastasis number≥4 were all risk factors for brain metastases in NSCLC patients after neoadjuvant chemotherapy(P<0.05).The calibration curves of both the model group and the validation group showed good consistency between the predicted values and the actual values.The area under the ROC curve in the model group was 0.759(95%CI:0.701-0.811),and that in the validation group was 0.788(95%CI:0.747-0.829).Analysis of decision curves revealed that within the specified threshold probability ranges(7%-81%for the model group and 4%-85%for the validation group),the nomogram consistently predicted a high net benefit value for NSCLC patients with brain metastasis after neoadjuvant chemotherapy.Conclusion:The nomogram model based on CECT radiomics demonstrates good accuracy and clinical application value,and can be used for the prediction of brain metastasis in NSCLC patients after neoadjuvant chemotherapy.
万方数据
维普
