Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma
Abstract Background This study aimed to develop a computed tomography (CT) model to predict Ki-67 expression in hepatocellular carcinoma (HCC) and to examine the added value of radiomics to clinico-radiological features. Methods A total of 208 patients (training set, n = 120; internal test set, n = ...
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| Format: | Article |
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BMC
2023-09-01
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| Series: | BMC Medical Imaging |
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| Online Access: | https://doi.org/10.1186/s12880-023-01069-4 |
| _version_ | 1827632729049530368 |
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| author | Yu-meng Zhao Shuang-shuang Xie Jian Wang Ya-min Zhang Wen-Cui Li Zhao-Xiang Ye Wen Shen |
| author_facet | Yu-meng Zhao Shuang-shuang Xie Jian Wang Ya-min Zhang Wen-Cui Li Zhao-Xiang Ye Wen Shen |
| author_sort | Yu-meng Zhao |
| collection | DOAJ |
| description | Abstract Background This study aimed to develop a computed tomography (CT) model to predict Ki-67 expression in hepatocellular carcinoma (HCC) and to examine the added value of radiomics to clinico-radiological features. Methods A total of 208 patients (training set, n = 120; internal test set, n = 51; external validation set, n = 37) with pathologically confirmed HCC who underwent contrast-enhanced CT (CE-CT) within 1 month before surgery were retrospectively included from January 2014 to September 2021. Radiomics features were extracted and selected from three phases of CE-CT images, least absolute shrinkage and selection operator regression (LASSO) was used to select features, and the rad-score was calculated. CE-CT imaging and clinical features were selected using univariate and multivariate analyses, respectively. Three prediction models, including clinic-radiologic (CR) model, rad-score (R) model, and clinic-radiologic-radiomic (CRR) model, were developed and validated using logistic regression analysis. The performance of different models for predicting Ki-67 expression was evaluated using the area under the receiver operating characteristic curve (AUROC) and decision curve analysis (DCA). Results HCCs with high Ki-67 expression were more likely to have high serum α-fetoprotein levels (P = 0.041, odds ratio [OR] 2.54, 95% confidence interval [CI]: 1.04–6.21), non-rim arterial phase hyperenhancement (P = 0.001, OR 15.13, 95% CI 2.87–79.76), portal vein tumor thrombus (P = 0.035, OR 3.19, 95% CI: 1.08–9.37), and two-trait predictor of venous invasion (P = 0.026, OR 14.04, 95% CI: 1.39–144.32). The CR model achieved relatively good and stable performance compared with the R model (AUC, 0.805 [95% CI: 0.683–0.926] vs. 0.678 [95% CI: 0.536–0.839], P = 0.211; and 0.805 [95% CI: 0.657–0.953] vs. 0.667 [95% CI: 0.495–0.839], P = 0.135) in the internal and external validation sets. After combining the CR model with the R model, the AUC of the CRR model increased to 0.903 (95% CI: 0.849–0.956) in the training set, which was significantly higher than that of the CR model (P = 0.0148). However, no significant differences were found between the CRR and CR models in the internal and external validation sets (P = 0.264 and P = 0.084, respectively). Conclusions Preoperative models based on clinical and CE-CT imaging features can be used to predict HCC with high Ki-67 expression accurately. However, radiomics cannot provide added value. |
| first_indexed | 2024-03-09T14:49:40Z |
| format | Article |
| id | doaj.art-c568ba173b024382b48f443ed2849080 |
| institution | Directory Open Access Journal |
| issn | 1471-2342 |
| language | English |
| last_indexed | 2024-03-09T14:49:40Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
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| series | BMC Medical Imaging |
| spelling | doaj.art-c568ba173b024382b48f443ed28490802023-11-26T14:35:14ZengBMCBMC Medical Imaging1471-23422023-09-0123111110.1186/s12880-023-01069-4Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinomaYu-meng Zhao0Shuang-shuang Xie1Jian Wang2Ya-min Zhang3Wen-Cui Li4Zhao-Xiang Ye5Wen Shen6Medical School of Nankai UniversityDepartment of Radiology, Tianjin First Center Hospital, Tianjin Institute of imaging medicine, School of Medicine, Nankai UniversityDepartment of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai UniversityDepartment of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai UniversityDepartment of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerDepartment of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for CancerDepartment of Radiology, Tianjin First Center Hospital, Tianjin Institute of imaging medicine, School of Medicine, Nankai UniversityAbstract Background This study aimed to develop a computed tomography (CT) model to predict Ki-67 expression in hepatocellular carcinoma (HCC) and to examine the added value of radiomics to clinico-radiological features. Methods A total of 208 patients (training set, n = 120; internal test set, n = 51; external validation set, n = 37) with pathologically confirmed HCC who underwent contrast-enhanced CT (CE-CT) within 1 month before surgery were retrospectively included from January 2014 to September 2021. Radiomics features were extracted and selected from three phases of CE-CT images, least absolute shrinkage and selection operator regression (LASSO) was used to select features, and the rad-score was calculated. CE-CT imaging and clinical features were selected using univariate and multivariate analyses, respectively. Three prediction models, including clinic-radiologic (CR) model, rad-score (R) model, and clinic-radiologic-radiomic (CRR) model, were developed and validated using logistic regression analysis. The performance of different models for predicting Ki-67 expression was evaluated using the area under the receiver operating characteristic curve (AUROC) and decision curve analysis (DCA). Results HCCs with high Ki-67 expression were more likely to have high serum α-fetoprotein levels (P = 0.041, odds ratio [OR] 2.54, 95% confidence interval [CI]: 1.04–6.21), non-rim arterial phase hyperenhancement (P = 0.001, OR 15.13, 95% CI 2.87–79.76), portal vein tumor thrombus (P = 0.035, OR 3.19, 95% CI: 1.08–9.37), and two-trait predictor of venous invasion (P = 0.026, OR 14.04, 95% CI: 1.39–144.32). The CR model achieved relatively good and stable performance compared with the R model (AUC, 0.805 [95% CI: 0.683–0.926] vs. 0.678 [95% CI: 0.536–0.839], P = 0.211; and 0.805 [95% CI: 0.657–0.953] vs. 0.667 [95% CI: 0.495–0.839], P = 0.135) in the internal and external validation sets. After combining the CR model with the R model, the AUC of the CRR model increased to 0.903 (95% CI: 0.849–0.956) in the training set, which was significantly higher than that of the CR model (P = 0.0148). However, no significant differences were found between the CRR and CR models in the internal and external validation sets (P = 0.264 and P = 0.084, respectively). Conclusions Preoperative models based on clinical and CE-CT imaging features can be used to predict HCC with high Ki-67 expression accurately. However, radiomics cannot provide added value.https://doi.org/10.1186/s12880-023-01069-4Hepatocellular carcinomaKi-67 expressionContrast-enhanced computed tomographyRadiomics |
| spellingShingle | Yu-meng Zhao Shuang-shuang Xie Jian Wang Ya-min Zhang Wen-Cui Li Zhao-Xiang Ye Wen Shen Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma BMC Medical Imaging Hepatocellular carcinoma Ki-67 expression Contrast-enhanced computed tomography Radiomics |
| title | Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma |
| title_full | Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma |
| title_fullStr | Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma |
| title_full_unstemmed | Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma |
| title_short | Added value of CE-CT radiomics to predict high Ki-67 expression in hepatocellular carcinoma |
| title_sort | added value of ce ct radiomics to predict high ki 67 expression in hepatocellular carcinoma |
| topic | Hepatocellular carcinoma Ki-67 expression Contrast-enhanced computed tomography Radiomics |
| url | https://doi.org/10.1186/s12880-023-01069-4 |
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