Abstract
Abstract
Background
This study aimed to develope and validate a radiomics nomogram by integrating the quantitative radiomics characteristics of No.3 lymph nodes (LNs) and primary tumors to better predict preoperative lymph node metastasis (LNM) in T1-2 gastric cancer (GC) patients.
Methods
A total of 159 T1-2 GC patients who had undergone surgery with lymphadenectomy between March 2012 and November 2017 were retrospectively collected and divided into a training cohort (n = 80) and a testing cohort (n = 79). Radiomic features were extracted from both tumor region and No. 3 station LNs based on computed tomography (CT) images per patient. Then, key features were selected using minimum redundancy maximum relevance algorithm and fed into two radiomic signatures, respectively. Meanwhile, the predictive performance of clinical risk factors was studied. Finally, a nomogram was built by merging radiomic signatures and clinical risk factors and evaluated by the area under the receiver operator characteristic curve (AUC) as well as decision curve.
Results
Two radiomic signatures, reflecting phenotypes of the tumor and LNs respectively, were significantly associated with LN metastasis. A nomogram incorporating two radiomic signatures and CT-reported LN metastasis status showed good discrimination of LN metastasis in both the training cohort (AUC 0.915; 95% confidence interval [CI] 0.832–0.998) and testing cohort (AUC 0.908; 95% CI 0.814–1.000). The decision curve also indicated its potential clinical usefulness.
Conclusions
The nomogram received favorable predictive accuracy in predicting No.3 LNM in T1-2 GC, and the nomogram showed positive role in predicting LNM in No.4 LNs. The nomogram may be used to predict LNM in T1-2 GC and could assist the choice of therapy.
Funder
the National Key R&D Program of China
National Natural Science Foundation of China
the Beijing Natural Science Foundation
the Bureau of International Cooperation of Chinese Academy of Sciences
the Youth Innovation Promotion Association CAS
Jiangsu Provincial Research Foundation for Basic Research of China
Zhenjiang Innovation Capacity Building Program (technological infrastructure) - R&D project of China
Jiangsu Provincial Key R&D Special Fund
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging
Cited by
11 articles.
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