医学
列线图
宫颈癌
逻辑回归
放射科
队列
淋巴结
卷积神经网络
阶段(地层学)
深度学习
肿瘤科
癌症
内科学
人工智能
古生物学
生物
计算机科学
作者
Pei-Jun Li,Bao Feng,Yu Liu,Yehang Chen,Haoyang Zhou,Yuan Chen,Wenming Li,Wansheng Long
标识
DOI:10.1177/02841851211058934
摘要
Background Deep learning (DL) has been used on medical images to grade, differentiate, and predict prognosis in many tumors. Purpose To explore the effect of computed tomography (CT)-based deep learning nomogram (DLN) for predicting cervical cancer lymph node metastasis (LNM) before surgery. Material and Methods In total, 418 patients with stage IB-IIB cervical cancer were retrospectively enrolled for model exploration (n = 296) and internal validation (n = 122); 62 patients from another independent institution were enrolled for external validation. A convolutional neural network (CNN) was used for DL features extracting from all lesions. The least absolute shrinkage and selection operator (Lasso) logistic regression was used to develop a deep learning signature (DLS). A DLN incorporating the DLS and clinical risk factors was proposed to predict LNM individually. The performance of the DLN was evaluated on internal and external validation cohorts. Results Stage, CT-reported pelvic lymph node status, and DLS were found to be independent predictors and could be used to construct the DLN. The combination showed a better performance than the clinical model and DLS. The proposed DLN had an area under the curve (AUC) of 0.925 in the training cohort, 0.771 in the internal validation cohort, and 0.790 in the external validation cohort. Decision curve analysis and stratification analysis suggested that the DLN has potential ability to generate a personalized probability of LNM in cervical cancer. Conclusion The proposed CT-based DLN could be used as a personalized non-invasive tool for preoperative prediction of LNM in cervical cancer, which could facilitate the choice of clinical treatment methods.
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