和测试组(20%),将术后病理学检查结果作为金标准。低风险组织学类型包括A、AB和B1。高风险组织学类型包括B2和B3。手动分割术前CECT图像相关肿瘤区域并提取影像组学特征。使用最小绝对收敛和选择算子(least absolute shrinkage and selection operator,LASSO)回归进行特征选择,并将临床特征添加到联合模型中。模型性能指标包括受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under curve,AUC)、灵敏度和特异度。
Preoperative risk categorization of thymoma is useful for treatment decisions but remains challenging. This study focused on training radiomics models using contrast-enhanced computed tomography (CECT) images for thymoma risk categorization and validating the model's performance
reliability and generalizability in a relatively large cohort.
Methods:
This retrospective cohort study analyzed the clinical data of thymoma patients (Masaoka Koga Ⅰ-Ⅲ) who underwent thymectomy surgery at the Affiliated Chest Hospital of Shanghai Jiao Tong University School of Medicine from January 2008 to December 2017. The cohort was divided into a training group (80%) and a test group (20%) using stratified random selection. The gold standard for histologic types was based on surgically resected specimens. Low-risk histologic types included A
AB and B1. High-risk histologic types included B2 and B3. Radiomics features were extracted from manually segmented regions of interest on preoperative CECT images. Interobserver correlation and least absolute shrinkage and selection operator (LASSO) regression were used for feature selection. Model performance metrics included area under the curve (AUC) of receiver operating characteristic (ROC) curve
sensitivity and specificity. Clinical characteristics were added to the combined model.
Results:
A total of 478 patients (mean age 51.3±12.3 years
48.1% was male) were included. The AUC of the cli
nical model
the CECT-based model
and the model using both clinical and CECT features on the test set were 0.666
0.831 and 0.850
respectively. The best performing model had a sensitivity of 0.829 and a specificity of 0.764.
Conclusion:
CECT-based radiomics models showed good performance in risk categorization of thymomas.
关键词
Keywords
references
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