基于不同时相增强CT的影像组学对胰腺实性假乳头状肿瘤侵袭性行为的预测价值

目的:探讨CT影像组学对胰腺实性假乳头状肿瘤（pSPN）侵袭性行为的预测价值。方法:回顾性分析2012年1月至2021年1月郑州大学第一附属医院经术后病理证实的pSPN患者的CT图像，其中侵袭性23例、非侵袭性59例。分别在平扫、动脉期和静脉期CT图像上逐层勾画感兴趣区（ROI）获得三维ROI，每个ROI提取1 316...

Multiphasic enhanced CT-based radiomics signature for preoperatively predicting the invasive behavior of pancreatic solid pseudopapillary neoplasm

Objective To explore the value of multiphasic CT-based radiomics signature in predicting the invasive behavior of pancreatic solid pseudopapillary neoplasm(pSPN).Methods The multiphasic CT images of patients with pSPN confirmed by postoperative pathology in the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2021 were analyzed retrospectively.There were 23 cases of invasiveness and 59 cases of non-invasiveness.The region of interest(ROI)was artificially delineated layer by layer in the plain scan,arterial-phase and venous-phase images,respectively.The 1316 image features were extracted from each ROI.The data set was divided into training and validation sets with a ratio of 7∶3 by stratified random sampling,and synthetic minority oversampling technique(SMOTE)algorithm was used for oversampling in the training set to generate invasive and non-invasive balanced data for building the training model.The constructed model was validated in the validation set.The receiver operating characteristic(ROC)analysis was used to evaluate model performance and the Delong′s test was applied to compare the area under the ROC curve(AUC)of different predict models.The improvement for classification efficiency of each independent model or their combinations were also assessed by net reclassification improvement(NRI)and integrated discrimination improvement(IDI)indices.Results After feature extraction,2,6 and 3 features were retained to construct plain-scanned model,arterial-phase and venous-phase models,respectively.Seven independent-phase and combined-phase models were established.Except the plain-scanned model,the AUC values of other models were greater than 0.800.The arterial-phase model had the best efficiency for classification among all independent-phase models.The AUC values of arterial-phase model in the SMOTE training and validation sets were 0.913 and 0.873,respectively.By combining the radiomics signature of the arterial-phase and venous-phase models,the AUC values of training and validation sets increased to 0.934 and 0.913 respectively.There were no significant differences of the AUC values between the scan-arterial venous-phase model and arterial venous-phase model in both training and validation sets(both P>0.05).The NRI and IDI indexes showed that the combined form of plain-scan model and arterial-venous-phase model could not significantly improve the classification efficiency in the validation set(both NRI and IDI<0).Conclusions The arterial-phase CT-based radiomics model has a good predictive performance in the invasive behavior of pSPN,and the combination with a venous-phase radiomics model can further improve the model performance.