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Non-invasive and real-time proliferative activity estimation based on a quantitative radiomics approach for patients with acromegaly: a multicenter study

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Abstract

Background

Proliferative activity prediction is important for determining individual treatment strategies for patients with acromegaly, and tumor proliferative activity is usually measured by the expression of Ki-67.

Objective

This study aimed to assess the value of a magnetic resonance imaging (MRI)-based radiomics approach in predicting the Ki-67 index of acromegaly patients.

Methods

A total of 138 patients with acromegaly were retrospectively reviewed and randomly assigned to primary and validation cohorts. Radiomics features were extracted from MR images, and then the elastic net and recursive feature elimination algorithms were applied to determine critical radiomics features for constructing a radiomics signature. Subsequently, multivariable logistic regression analysis was used to select the most informative clinical features, and a radiomics nomogram incorporating a radiomics signature and selected clinical features was constructed for individual predictions. Twenty-five acromegaly patients were enrolled for multicenter model validation.

Results

Seventeen radiomics features were selected to construct a radiomics signature that achieved an area under the curve (AUC) value of 0.96 and 0.89 in the primary cohort and the validation cohort, respectively. A radiomics nomogram that incorporated the radiomics signature and eight selected clinical features was constructed and showed good discrimination and calibration, with an AUC of 0.94 in the primary cohort and 0.91 in the validation cohort. The radiomics signature in the multicenter validation achieved an accuracy of 88.2%. The analysis of the decision curve showed that the radiomics signature and radiomics nomogram were clinically useful for patients with acromegaly.

Conclusions

The radiomics signature developed in this study could aid neurosurgeons in predicting the Ki-67 index of patients with acromegaly and could contribute to non-invasive measurement of proliferative activity, affecting individual treatment strategies.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

We thank H. Nikki March, PhD, from Liwen Bianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This work was supported by the Graduate Innovation Fund of Peking Union Medical College (2018-1002-01-10), Natural Science Foundation of Beijing Municipality (Grant No. 7182137), Capital Characteristic Clinic Project (Grant No. Z16100000516092), and Chinese Academy of Medical Sciences (Grant No. 2017-I2M-3-014).

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Author notes

  1. Y. Fan, Y. Chai, and K. Li contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dongcheng District, Beijing, 100730, China

    Y. Fan, S. Feng, M. Feng & R. Wang

  2. Department of Neurosurgery, Yuquan Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 100040, China

    Y. Chai

  3. School of Queen Mary, Nanchang University, Nanchang, 330006, Jiangxi Province, China

    K. Li

  4. Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China

    H. Fang

  5. Department of Radiology, Sichuan Academy of Medical Sciences, Sichuan Provincial People’s Hospital, Chengdu, 610072, Sichuan Province, China

    A. Mou

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Contributions

All authors provided contributions to study conception and design, acquisition of data or analysis and interpretation of data, drafting of the article, or revising it critically for important intellectual content, and final approval of the version to be published. All authors analyzed and interpreted the data. Yanghua Fan, Yi Chai and Kuangxun Li revised the manuscript for important intellectual content. Renzhi Wang and Ming Feng take final responsibility for this article.

Corresponding authors

Correspondence to M. Feng or R. Wang.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All the patients were informed about the purposes of the study and consequently have signed their “consent of the patient”. All investigations conformed to the principles outlined in the Declaration of Helsinki and were performed with permission by the responsible Ethics Committee of the Institutional Review Board of Peking Union Medical College Hospital.

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All participants provided informed consent prior to their participation.

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Fan, Y., Chai, Y., Li, K. et al. Non-invasive and real-time proliferative activity estimation based on a quantitative radiomics approach for patients with acromegaly: a multicenter study. J Endocrinol Invest 43, 755–765 (2020). https://doi.org/10.1007/s40618-019-01159-7

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  • DOI: https://doi.org/10.1007/s40618-019-01159-7

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