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CT enterography-based radiomics combined with body composition to predict infliximab treatment failure in Crohn’s disease

  • Abdominal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

Accurately predicting the treatment response in patients with Crohn’s disease (CD) receiving infliximab therapy is crucial for clinical decision-making. We aimed to construct a prediction model incorporating radiomics and body composition features derived from computed tomography (CT) enterography for identifying individuals at high risk for infliximab treatment failure.

Methods

This retrospective study included 137 patients with CD between 2015 and 2021, who were divided into a training cohort and a validation cohort with a ratio of 7:3. Patients underwent CT enterography examinations within 1 month before infliximab initiation. Radiomic features of the intestinal segments involved were extracted, and body composition features were measured at the level of the L3 lumbar vertebra. A model that combined radiomics with body composition was constructed. The primary outcome was the occurrence of infliximab treatment failure within 1 year. The model performance was evaluated using discrimination, calibration, and decision curves.

Results

Fifty-two patients (38.0%) showed infliximab treatment failure. Eight significant radiomic features were used to develop the radiomics model. The model incorporating radiomics model score, skeletal muscle index (SMI), and creeping fat showed good discrimination for predicting infliximab treatment failure, with an area under the curve (AUC) of 0.88 (95% CI 0.81, 0.95) in the training cohort and 0.83 (95% CI 0.66, 1.00) in the validation cohort. The favorable clinical application was observed using decision curve analysis.

Conclusions

We constructed a comprehensive model incorporating radiomics and muscle volume, which could potentially be used to facilitate the individualized prediction of infliximab treatment response in patients with CD.

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Data availability

Data are available upon reasonable request and pursuant to appropriate agreements.

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Acknowledgements

Thanks to Professor Liu Zhenguo who played an important role in the revision process of the paper and helped with the language revision.

Funding

This work was supported by the National Natural Science Foundation of China (81771827 and 82071986), the Science and Technology Project of Hunan Province (2021RC4017), the Furong Scholars Programme of Hunan Province (2022), and the Wisdom Accumulation and Talent Cultivation Project of the Third Xiangya Hospital of Central South University (2020).

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Authors and Affiliations

  1. Department of Radiology, Third Xiangya Hospital, Central South University, No. 138 Tongzipo Road, Changsha, 410013, Hunan, China

    Fulong Song, Mengtian Ma, Shumin Zeng, Fang Shao, Weiyan Huang, Zhichao Feng & Pengfei Rong

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Contributions

All authors approved the final version of the article, including the authorship list. The scientific guarantor of this publication is FS who performed data analysis, figure visualizations, and initial draft writing. MM and ZF kindly provided statistical advice for this manuscript. PR and ZF provided clinical input on experimental design, assistance in editing the manuscript and jointly conceived and supervised the project, designed the experiments, oversaw the analysis, and wrote and edited the final manuscript. WH, FS, and SZ performed detailed chart review, extracted clinical variables, quality evaluation, and radiomic analysis of CT enterography scans.

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Correspondence to Zhichao Feng or Pengfei Rong.

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Institutional Review Board approval from the Ethics Committee of The Third Xiangya Hospital of Central South University (Changsha, China) was obtained.

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Song, F., Ma, M., Zeng, S. et al. CT enterography-based radiomics combined with body composition to predict infliximab treatment failure in Crohn’s disease. Radiol med 129, 175–187 (2024). https://doi.org/10.1007/s11547-023-01748-w

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