Is the radiomics-clinical combined model helpful in distinguishing between pancreatic cancer and mass-forming pancreatitis?

医学 队列 无线电技术 胰腺癌 放射科 胰腺炎 内科学 癌症
作者
Weinuo Qu,Ziling Zhou,Guanjie Yuan,Shichao Li,Jiali Li,Qian Chu,Qingpeng Zhang,Qingguo Xie,Zhen Li,Ihab R. Kamel
出处
期刊:European Journal of Radiology [Elsevier BV]
卷期号:164: 110857-110857
标识
DOI:10.1016/j.ejrad.2023.110857
摘要

To develop CT-based radiomics models for distinguishing between resectable PDAC and mass-forming pancreatitis (MFP) and to provide a non-invasive tool for cases of equivocal imaging findings with EUS-FNA needed.A total of 201 patients with resectable PDAC and 54 patients with MFP were included. Development cohort: patients without preoperative EUS-FNA (175 PDAC cases, 38 MFP cases); validation cohort: patients with EUS-FNA (26 PDAC cases, 16 MFP cases). Two radiomic signatures (LASSOscore, PCAscore) were developed based on the LASSO model and principal component analysis. LASSOCli and PCACli prediction models were established by combining clinical features with CT radiomic features. ROC analysis and decision curve analysis (DCA) were performed to evaluate the utility of the model versus EUS-FNA in the validation cohort.In the validation cohort, the radiomic signatures (LASSOscore, PCAscore) were both effective in distinguishing between resectable PDAC and MFP (AUCLASSO = 0.743, 95% CI: 0.590-0.896; AUCPCA = 0.788, 95% CI: 0.639-0.938) and improved the diagnostic accuracy of the baseline onlyCli model (AUConlyCli = 0.760, 95% CI: 0.614-0.960) after combination with variables including age, CA19-9, and the double-duct sign (AUCPCACli = 0.880, 95% CI: 0.776-0.983; AUCLASSOCli = 0.825, 95% CI: 0.694-0.955). The PCACli model showed comparable performance to FNA (AUCFNA = 0.810, 95% CI: 0.685-0.935). In DCA, the net benefit of the PCACli model was superior to that of EUS-FNA, avoiding biopsies in 70 per 1000 patients at a risk threshold of 35%.The PCACli model showed comparable performance with EUS-FNA in discriminating resectable PDAC from MFP.
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