Dataset Information

Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions.

ABSTRACT: Radiomics, also known as quantitative imaging or texture analysis, involves extracting a large number of features traditionally unmeasured in conventional radiological cross-sectional images and converting them into mathematical models. This review describes this approach and its use in the evaluation of pancreatic cystic lesions (PCLs). This discipline has the potential of more accurately assessing, classifying, risk stratifying, and guiding the management of PCLs. Existing studies have provided important insight into the role of radiomics in managing PCLs. Although these studies are limited by the use of retrospective design, single center data, and small sample sizes, radiomic features in combination with clinical data appear to be superior to the current standard of care in differentiating cyst type and in identifying mucinous PCLs with high-grade dysplasia. Combining radiomic features with other novel endoscopic diagnostics, including cyst fluid molecular analysis and confocal endomicroscopy, can potentially optimize the predictive accuracy of these models. There is a need for multicenter prospective studies to elucidate the role of radiomics in the management of PCLs.

SUBMITTER: Machicado JD

PROVIDER: S-EPMC7399814 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions.

Machicado Jorge D JD Koay Eugene J EJ Krishna Somashekar G SG

Diagnostics (Basel, Switzerland) 20200721 7

Radiomics, also known as quantitative imaging or texture analysis, involves extracting a large number of features traditionally unmeasured in conventional radiological cross-sectional images and converting them into mathematical models. This review describes this approach and its use in the evaluation of pancreatic cystic lesions (PCLs). This discipline has the potential of more accurately assessing, classifying, risk stratifying, and guiding the management of PCLs. Existing studies have provide ...[more]

PMID: 32708348

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Project description:BackgroundSerous cystic neoplasm (SCN), mucinous cystic neoplasm (MCN), and intraductal papillary mucinous neoplasm (IPMN) comprise a large proportion of pancreatic cystic neoplasms (PCNs). Patients with MCN and IPMN require surgery due to the potential of malignant transformation, whereas those with SCN require periodic surveillance. However, the differential diagnosis of patients with PCNs before treatment remains a great challenge for all surgeons. Therefore, the establishment of a reliable diagnostic tool is urgently required for the improvement of precision diagnostics.MethodsBetween February 2015 and December 2020, 143 consecutive patients with PCNs who were confirmed by postoperative pathology were retrospectively included in the study cohort, then randomized into development and test cohorts at a ratio of 7:3. The predictors of preoperative clinical-radiologic parameters were evaluated by univariate and multivariable logistic regression analyses. A total of 1,218 radiomics features were computationally extracted from the enhanced computed tomography (CT) scans of the tumor region, and a radiomics signature was established by the random forest algorithm. In the development cohort, multi- and binary-class radiomics models integrating preoperative variables and radiomics features were constructed to distinguish between the 3 types of PCNs. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the predictive efficiency of the model. An independent internal test cohort was applied to validate the classification models.ResultsAll preoperative prediction models were built by integrating the radiomics signature with 13 diagnosis-related radiomics features and 3 important clinical-radiologic parameters: age, sex, and tumor diameter. The multiclass prediction model presented an overall accuracy of 0.804 in the development cohort and 0.707 in the test cohort. The binary-class prediction models displayed higher overall accuracies of 0.853, 0.866, and 0.928 in the development dataset and 0.750, 0.839, and 0.889 in the test dataset. In the test cohort, the binary-class radiomics models showed better predictive performances {AUC =0.914 [95% confidence interval (CI): 0.786 to 1.000], 0.863 (95% CI: 0.714 to 0.941), and 0.926 (95% CI: 0.824 to 1.000)} than the multiclass radiomics model [AUC =0.850 (95% CI: 0.696 to 1.000)], with a large net benefit in the decision curve analysis (DCA). The radiomics-based nomogram provided the correct predicted probability for the diagnosis of PCNs.ConclusionsThe proposed radiomics models with clinical-radiologic parameters and radiomics features help to predict the accurate diagnosis among PCNs to advance personalized medicine.

Project description:Background: Serous cystadenoma (SCA), mucinous cystadenoma (MCN), and intraductal papillary mucinous neoplasm (IPMN) are three subtypes of pancreatic cystic neoplasm (PCN). Due to the potential of malignant-transforming, patients with MCN and IPMN require radical surgery while patients with SCA need periodic surveillance. However, accurate pre-surgery diagnosis between SCA, MCN, and IPMN remains challenging in the clinic. Methods: This study enrolled 164 patients including 76 with SCA, 40 with MCN and 48 with IPMN. Patients were randomly split into a training cohort (n = 115) and validation cohort (n = 41). We performed statistical analysis and Boruta method to screen significantly distinct clinical factors and radiomics features extracted on pre-surgery contrast-enhanced computed tomography (CECT) images among three subtypes. Three reliable machine-learning algorithms, support vector machine (SVM), random forest (RF) and artificial neural network (ANN), were utilized to construct classifiers based on important radiomics features and clinical parameters. Precision, recall, and F1-score were calculated to assess the performance of the constructed classifiers. Results: Nine of 547 radiomics features and eight clinical factors showed a significant difference among SCA, MCN, and IPMN. Five radiomics features (Histogram_Entropy, Histogram_Skeweness, LLL_GLSZM_GLV, Histogram_Uniformity, HHL_Histogram_Kurtosis), and four clinical factors, including serum carbohydrate antigen 19-9, sex, age, and serum carcinoembryonic antigen, were identified important by Boruta method. The SVM classifier achieved an overall accuracy of 73.04% in training cohort and 71.43% in validation cohort, respectively. The RF classifier achieved overall accuracy of 84.35 and 79.59%, respectively. The constructed ANN model showed an overall accuracy of 77.39% in the training dataset and 71.43% in the validation dataset. All the three classifiers showed high F1 score for differentiation among the three subtypes. Conclusion: Our study proved the feasibility and translational value of CECT-based radiomics classifiers for differentiation among SCA, MCN, and IPMN.

Dataset Information

Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions.

Publications

Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions.

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