首页|治疗前18F-FDG PET/CT影像组学特征在弥漫大B细胞淋巴瘤预后评估中的增益作用

治疗前18F-FDG PET/CT影像组学特征在弥漫大B细胞淋巴瘤预后评估中的增益作用

Enhancement Effect of Pre-Treatment 18F-FDG PET/CT Radiomic Features in Prognostic Evaluation of Diffuse Large B-Cell Lymphoma

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目的 探讨治疗前 18F-FDG PET/CT影像组学特征对弥漫大B细胞淋巴瘤(DLBCL)患者无进展生存期(PFS)及总生存期(OS)的预后评估.资料与方法 回顾性收集2016年 1 月—2018年12 月解放军总医院第一医学中心经病理证实为DLBCL且治疗前行 18F-FDG PET/CT的 135 例患者,以 8∶2 随机分为训练集和测试集,再以 8∶2 将训练集分为训练集和验证集进行模型构建.半自动勾画患者淋巴瘤病灶作为感兴趣区并提取特征,利用单因素COX及最小绝对收缩选择算子回归进行特征筛选,获得系数非零的影像组学特征并用其权重系数计算每例患者的影像组学得分(Radscore),分析Radscore对PFS和OS的预测价值.使用传统预后指标(代谢参数和临床因素)、Radscore及两者联合分别建立3种模型.通过C-index、时间依赖的受试者工作特征曲线、决策曲线评估各模型预测效能.最后基于最佳模型绘制列线图,利用校准曲线验证列线图效能.结果 联合模型对3、5年PFS及OS预测效能优于传统预后指标模型和Radscore模型(Z=0.962 1~2.253 9,P均<0.05).决策曲线显示,联合模型获得最大临床净增益.校准曲线显示,列线图的预测值与实际观察值一致性均良好.结论 Radscore是预测DLBCL患者生存的独立预后因素.联合模型对指导临床个体化治疗方案制订有较大的应用价值.
Purpose To investigate the predictive value of 18F-FDG PET/CT radiomic features before treatment for progression free survival(PFS)and overall survival(OS)in diffuse large B-cell lymphoma(DLBCL).Materials and Methods A total of 135 patients with pathologically proven DLBCL in Chinese PLA General Hospital from January 2016 to December 2018 and 18F-FDG PET/CT imaging prior to treatment were retrospectively collected.Patients were randomly divided into training set and test set using 8∶2,and then the training set was divided into training set and verification set using 8∶2 to construct the model.Semi-automatically delineated patients'lymphoma lesions as regions of interest and extracted the features.Univariate COX and least absolute shrinkage and selection operator regression were used to screen the features,and the non-zero radiomic features were obtained and the weight coefficients were used to calculate the Radscore value of each patient,and the predictive value of Radscore on PFS and OS was analyzed.Three models were established using traditional prognostic indicators(metabolic parameters and clinical factors),Radscore and combination.C-index,time-dependent area under the curve and decision curve were used to evaluate the model prediction efficiency.Finally,based on the optimal model,a column diagram was drawn,and the calibration curve was used to verify the efficiency of the column diagram.Results The combined model predicted PFS and OS at 3 and 5 years better than the traditional prognostic index model and Radscore model(Z=0.962 1-2.253 9,all P<0.05).Decision curve showed that the combined model achieved the greatest clinical net benefit.The calibration curve showed that the predicted values of the nomogram were in good agreement with the observed values.Conclusion Radscore is an independent prognostic factor for survival in DLBCL patients.The combined model has great application value in guiding the formulation of clinical individualized treatment plan.

Diffuse large B-cell lymphomaPositron-emission tomographyFluorodeoxyribose F18RadiomicsPrognosis

孟晓琳、潘越、崔景景、孙树伟、周晖、王瑞民

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解放军总医院第一医学中心核医学科,北京 100853

联影智能医疗科技有限公司,北京 100094

弥漫大B细胞淋巴瘤 正电子发射断层摄影术 氟脱氧核糖F18 影像组学 预后

2024

中国医学影像学杂志
中国医学影像技术研究会

中国医学影像学杂志

CSTPCD北大核心
影响因子:1.37
ISSN:1005-5185
年,卷(期):2024.32(3)
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