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Prognostic predictive value of urothelial carcinoma of the bladder after TURBT based on multiphase CT radiomics

  • Kidneys, Ureters, Bladder, Retroperitoneum
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To investigate multiphase computed tomography (CT) radiomics-based combined with clinical factors to predict overall survival (OS) in patients with bladder urothelial carcinoma (BLCA) who underwent transurethral resection of bladder tumor (TURBT).

Methods

Data were retrospectively collected from 114 patients with primary BLCA from February 2016 to February 2018. The regions of interest (ROIs) of the plain, arterial, and venous phase images were manually segmented. The Cox regression algorithm was used to establish 3 basic models for the plain phase (PP), arterial phase (AP), and venous phase (VP) and 2 combination models (AP + VP and PP + AP + VP). The highest-performing radiomics model was selected to calculate the radiomics score (Rad-score), and independent risk factors affecting patients’ OS were analyzed using Cox regression. The Rad-score and clinical risk factors were combined to construct a joint model and draw a visualized nomogram.

Results

The combined model of PP + AP + VP showed the best performance with the Akaike Information Criterion (AIC) and Consistency Index (C-index) in the test group of 130.48 and 0.779, respectively. A combined model constructed with two independent risk factors (age and Ki-67 expression status) in combination with the Rad-score outperformed the radiomics model alone; AIC and C-index in the test group were 115.74 and 0.840, respectively. The calibration curves showed good agreement between the predicted probabilities of the joint model and the actual (p < 0.05). The decision curve showed that the joint model had good clinical application value within a large range of threshold probabilities.

Conclusion

This new model can be used to predict the OS of patients with BLCA who underwent TURBT.

Graphical abstract

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors greatly appreciate all the patients and their families for participating in this trial. We also express our gratitude to the staffs from our Hospital for their selfless dedication. The authors would like to thank the clinicians in the Department of Medical Imaging, The Affiliated Hospital of Jiangsu University for their professional clinical advice.

Funding

This work was supported by a Key project of Jiangsu Provincial Health Commission [Grant Number: K2019024]; Natural Science Foundation of Jiangsu Province [Grant Number: BK20191223]; Scientific research project of Jinshan Talent Training Program for high-level leading Talents [Grant Number: YLJ202111].

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Author notes

  1. Dongqing Wang & Lirong Zhang

    Present address: Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China

  2. Jing Xue and Zijian Zhuang have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China

    Jing Xue, Zijian Zhuang & Haitao Zhu

  2. School of Medicine, Jiangsu University, Zhenjiang, 212001, Jiangsu, China

    Lin Peng & Xingchi Chen

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Contributions

XJ and ZZJ contributed equally to this work. WDQ, XJ, ZZJ, and ZLR contributed to the conception of the study. PL and CXC performed the data measurement. XJ performed the model development. XJ, ZLR, and ZZJ contributed significantly to analysis and manuscript preparation. WDQ and XJ performed the data analysis and wrote the manuscript. ZHT, ZZJ, ZLR, and WDQ helped to perform the analysis with constructive discussions. Both ZLR and WDQ are corresponding authors. All authors contributed to the article and approved the submitted version.

Corresponding authors

Correspondence to Dongqing Wang or Lirong Zhang.

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Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Affiliated Hospital of Jiangsu University (Approval Number: KY2023K0304), and did not require written informed consent due to its retrospective nature.

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The authors affirm that human research participants provided informed consent for the publication of the images in Figs. 2 and 3.

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Xue, J., Zhuang, Z., Peng, L. et al. Prognostic predictive value of urothelial carcinoma of the bladder after TURBT based on multiphase CT radiomics. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04265-0

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  • DOI: https://doi.org/10.1007/s00261-024-04265-0

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