MRI 术前预测肝细胞癌微血管侵犯风险:瘤周与肿瘤区域。
Preoperative prediction of microvascular invasion risk in hepatocellular carcinoma with MRI: peritumoral versus tumor region.
发表日期:2024 Aug 01
作者:
Guangya Wei, Guoxu Fang, Pengfei Guo, Peng Fang, Tongming Wang, Kecan Lin, Jingfeng Liu
来源:
Insights into Imaging
摘要:
探讨肿瘤和多个瘤周区域在动态对比增强磁共振成像 (MRI) 上的预测性能,以确定最佳感兴趣区域,以开发微血管侵犯分级 (MVI) 的术前预测模型。 共有 147 名患者招募经手术诊断为肝细胞癌、最大肿瘤直径≤≤5cm的患者,根据手术日期分为训练组(n=117)和测试组(n=30)。我们利用预先训练的 AlexNet 从各种 MRI 序列图像中肿瘤最大横截面的七个不同区域中提取深度学习特征。随后,采用极限梯度增强(XGBoost)分类器构建MVI等级预测模型,并根据曲线下面积(AUC)进行评估。使用来自20毫米瘤周区域的数据训练的XGBoost分类器显示出优于相比的AUC仅针对肿瘤区域。当利用 5 毫米、10 毫米和 20 毫米瘤周区域的数据时,AUC 值持续增加。结合动脉和延迟相数据产生了最高的预测性能,微观和宏观平均 AUC 分别为 0.78 和 0.74。临床数据的整合进一步将AUC值提高至0.83和0.80。与肿瘤区域相比,瘤周区域的深度学习特征为预测MVI分级提供了更重要的信息。将肿瘤区域和20mm瘤周区域结合起来,得到了一个相对理想且准确的区域,可以预测MVI的分级。20mm瘤周区域比肿瘤区域对MVI分级的预测更有意义。深度学习特征可以通过从肿瘤区域提取信息并直接从瘤周区域捕获MVI信息来间接预测MVI。我们研究了肿瘤和不同瘤周区域以及它们的融合。 MVI 主要发生在肿瘤周围区域,与肿瘤区域相比,这是一个更好的预测因子。瘤周 20mm 区域对于准确预测三级 MVI 是合理的。© 2024。作者。
To explore the predictive performance of tumor and multiple peritumoral regions on dynamic contrast-enhanced magnetic resonance imaging (MRI), to identify optimal regions of interest for developing a preoperative predictive model for the grade of microvascular invasion (MVI).A total of 147 patients who were surgically diagnosed with hepatocellular carcinoma, and had a maximum tumor diameter ≤ 5 cm were recruited and subsequently divided into a training set (n = 117) and a testing set (n = 30) based on the date of surgery. We utilized a pre-trained AlexNet to extract deep learning features from seven different regions of the maximum transverse cross-section of tumors in various MRI sequence images. Subsequently, an extreme gradient boosting (XGBoost) classifier was employed to construct the MVI grade prediction model, with evaluation based on the area under the curve (AUC).The XGBoost classifier trained with data from the 20-mm peritumoral region showed superior AUC compared to the tumor region alone. AUC values consistently increased when utilizing data from 5-mm, 10-mm, and 20-mm peritumoral regions. Combining arterial and delayed-phase data yielded the highest predictive performance, with micro- and macro-average AUCs of 0.78 and 0.74, respectively. Integration of clinical data further improved AUCs values to 0.83 and 0.80.Compared with those of the tumor region, the deep learning features of the peritumoral region provide more important information for predicting the grade of MVI. Combining the tumor region and the 20-mm peritumoral region resulted in a relatively ideal and accurate region within which the grade of MVI can be predicted.The 20-mm peritumoral region holds more significance than the tumor region in predicting MVI grade. Deep learning features can indirectly predict MVI by extracting information from the tumor region and directly capturing MVI information from the peritumoral region.We investigated tumor and different peritumoral regions, as well as their fusion. MVI predominantly occurs in the peritumoral region, a superior predictor compared to the tumor region. The peritumoral 20 mm region is reasonable for accurately predicting the three-grade MVI.© 2024. The Author(s).