医学
列线图
接收机工作特性
无线电技术
胰腺导管腺癌
鉴别诊断
胰腺癌
曲线下面积
队列
放射科
胰腺
胰腺肿瘤
腺癌
病理
神经内分泌肿瘤
内科学
转移
肿瘤科
癌症
作者
Mingguang He,Zhenyu Liu,Yusong Lin,Jianzhong Wan,Juan Li,Kai Xu,Yun Wang,Zhengyu Jin,Jie Tian,Huadan Xue
标识
DOI:10.1016/j.ejrad.2019.05.024
摘要
To develop and validate an effective model to differentiate NF-pNET from PDAC. Between July 2014 and December 2017, 147 patients (80 patients with PDAC and 67 patients with atypical NF-pNET) with pathology results and enhanced CT were consecutively enrolled and chronologically divided into primary and validation cohorts. Three models were built to differentiate atypical NF-pNET from PDAC, including a model based on radiomic signature alone, one based on clinicoradiological features alone and one that integrated the two. The diagnostic performance of the three models was estimated and compared with the area under the receiver operating characteristic curve (AUC) in the validation cohort. A nomogram was used to represent the model with the best performance, and the associated calibration was also assessed. In the validation cohort, the AUC for differential diagnosis was 0.884 with the integrated model, which was significantly improved over that of the model based on clinicoradiological features (AUC = 0.775, p value = 0.004) and was comparable to that of the model based on the radiomic signature (AUC = 0.873, p value = 0.512). The nomogram representing the integrated model achieved good discrimination performances in both the primary and validation cohorts, with C-indices of 0.960 and 0.884, respectively. The integrated model outperformed the model based on clinicoradiological features alone and was comparable to the model based on the radiomic signature alone with respect to the differential diagnosis of atypical NF-pNET and PDAC. The nomogram achieved an optimal preoperative, noninvasive differential diagnosis between atypical pNET and PDAC, which can better inform therapeutic choice in clinical practice.
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