Feasibility Analysis of Arterial CT Radiomics Model to Predict the Risk of Local and Metastatic Recurrence after Radical Cystectomy for Bladder Cancer

Abstract

Abstract Purpose To construct a radiomics-clinical nomogram model for predicting the risk of local and metastatic recurrence within 3 years after radical cystectomy (RC) of bladder cancer (BCa) based on the radiomic features and important clinical risk factors for arterial computed tomography (CT) images and to evaluate its efficacy. Methods Preoperative CT datasets of 134 BCa patients (24 recurrent) who underwent RC were collected and divided into training (n = 93) and validation sets (n = 41). Radiomics features were extracted from a 1.5 mm CT layer thickness image in the arterial phase. A radiomics score (Rad-Score) model was constructed using the recursive feature elimination approach and a logistic regression model. Combined with important clinical factors, including gender, age, tumor size, tumor number and grade, pathologic T stage, lymph node stage and histology type of the archived lesion, and CT image signs, a radiomics-clinical nomogram was developed, and its performance was evaluated in the training and validation sets. Decision curve analyses (DCA) the potential clinical usefulness. Results The radiomics feature, consisting of five recurrence-related features, achieved good predictive results. The radiomics nomogram developed by combining two independent predictors, Rad-Score and pathologic T stage, was developed in the training set [AUC, 0.840; 95% confidence interval (CI), 0.743–0.937] and validation set (AUC, 0.883; 95% CI, 0.777–0.989). The calibration curve showed good agreement between the predicted probability of the radiomics-clinical model and the actual recurrence rate within 3 years after radical cystectomy for BCa. DCA show the clinical application value of the radiomics clinical model. Conclusion The radiomics clinical nomogram model constructed based on the radiomics features of arterial CT images and important clinical risk factors is potentially feasible for predicting the risk of recurrence within 3 years after RC for BCa.