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Preoperative differentiation of serous cystic neoplasms from mucin-producing pancreatic cystic neoplasms using a CT-based radiomics nomogram

  • Pancreas
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Abstract

Purpose

To develop and validate a CT-based radiomics nomogram in preoperative differential diagnosis of SCNs from mucin-producing PCNs.

Material and methods

A total of 89 patients consisting of 31 SCNs, 30 IPMNs, and 28 MCNs who underwent preoperative CT were analyzed. A total of 710 radiomics features were extracted from each case. Patients were divided into training (n = 63) and validation cohorts (n = 26) with a ratio of 7:3. Least absolute shrinkage and selection operator (LASSO) method and logistic regression analysis were used for feature selection and model construction. A nomogram was created from a comprehensive model consisting of clinical features and the fusion radiomics signature. A decision curve analysis was used for clinical decisions.

Results

The radiomics features extracted from CT could assist with the differentiation of SCNs from mucin-producing PCNs in both the training and validation cohorts. The signature of the combination of the plain, late arterial, and venous phases had the largest areas under the curve (AUCs) of 0.960 (95% CI 0.910–1) in the training cohort and 0.817 (95% CI 0.651–0.983) in the validation cohort with good calibration. The value and efficacy of the nomogram was verified using decision curve analysis.

Conclusion

A comprehensive nomogram incorporating clinical features and fusion radiomics signature can differentiate SCNs from mucin-producing PCNs.

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Data availability

All datasets presented in this study are included in the article/supplementary material.

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Acknowledgements

We thank all authors for their continuous and excellent support with patient data collection, imaging analysis, statistical analysis and valuable suggestions for the article.

Funding

This study was funded by the National Natural Science Foundation of China (No. 81771899) for Zhongqiu Wang, Postgraduate Research & Practice Innovation Program of Jiangsu Province (No. KYCX20_1477) for Shuai Ren, China Scholarship Council (No. 201909077001) for Shuai Ren, Jiangsu Provincial Key research and development program (No. BE2017772) for Zhongqiu Wang, Administration of Traditional Chinese Medicine of Jiangsu Province (No. ZD201907) for Zhongqiu Wang, and Developing Program for High-level Academic Talent in Jiangsu Hospital of TCM (No. y2018rc04) for Zhongqiu Wang.

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Author notes

  1. Shuai Chen and Shuai Ren contributed equally to this work

Authors and Affiliations

  1. Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, Jiangsu, China

    Shuai Chen, Shuai Ren, Kai Guo & Zhongqiu Wang

  2. Department of Diagnostic Radiology and Nuclear Medicine, School of Medicine, University of Maryland, Baltimore, MD, 21201, USA

    Shuai Ren & Rong Chen

  3. Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA

    Marcus J. Daniels

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  1. Shuai Chen
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Contributions

Study design and funds collection: SC, SR, ZQW; provision of study materials or patients: SC, KG; data processing, analysis, and interpretation: SC, SR, RC; manuscript writing and editing: SR, MJD, ZQW, RC.

Corresponding author

Correspondence to Zhongqiu Wang.

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We declare no competing interests.

Ethical approval

This study was a retrospective study, which was approved by the institutional review board of our hospital (2017NL-137-05), wherein the requirements for informed consent was waived due to its retrospective nature.

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Chen, S., Ren, S., Guo, K. et al. Preoperative differentiation of serous cystic neoplasms from mucin-producing pancreatic cystic neoplasms using a CT-based radiomics nomogram. Abdom Radiol 46, 2637–2646 (2021). https://doi.org/10.1007/s00261-021-02954-8

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  • DOI: https://doi.org/10.1007/s00261-021-02954-8

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