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Radiomics analysis using contrast-enhanced CT for preoperative prediction of occult peritoneal metastasis in advanced gastric cancer

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate the predictive value of CT radiomics features derived from the primary tumor in discriminating occult peritoneal metastasis (PM) in advanced gastric cancer (AGC).

Methods

Preoperative CT images of 233 patients with AGC were retrospectively analyzed. The region of interest (ROI) was manually drawn along the margin of the lesion on the largest slice of venous CT images, and a total of 539 quantified features were extracted automatically. The intra-class correlation coefficient (ICC) and the absolute correlation coefficient (ACC) were calculated for selecting influential features. A multivariate logistic regression model was constructed based on the training cohort, and the testing cohort validated the reliability of the model. Additionally, another model based on the preoperative clinic-pathological features was also developed. The comparison of the diagnostic performance between the two models was performed using ROC analysis and the Akaike information criterion (AIC) value.

Results

Six radiomics features (ID_Energy, LoG(0.5)_Energy, Compactness2, Max Diameter, Orientation, and Surface Area Density) differed significantly between AGCs with and without PM and performed well in distinguishing AGCs with PM from those without PM in the primary cohort (AUC = 0.618–0.658). The radiomics model showed a higher AUC value than each single radiomics feature in the primary cohort (0.741 vs. 0.618–0.658) and similar diagnosis performance in the validation cohort. The radiomics model showed slightly worse diagnostic efficacy than the clinic-pathological model (AUC, 0.724 vs. 0.762).

Conclusion

Venous CT radiomics analysis based on the primary tumor provided valuable information for predicting occult PM in AGCs.

Key Points

• Venous CT radiomics analysis provided valuable information for predicting occult peritoneal metastases in advanced gastric cancer.

• CT-based T stage was an independent predictive factor of occult peritoneal metastases in advanced gastric cancer.

• A radiomics model showed slightly worse diagnostic efficacy than a clinic-pathological model.

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Abbreviations

ACC:

Absolute correlation coefficient

AGC:

Advanced gastric cancer

AIC:

Akaike information criterion

AUC:

Area under the curve

HU:

Hounsfield unit

ICC:

Intra-class correlation coefficient

PM:

Peritoneal metastasis

ROC:

Receiver operating characteristic

ROI:

Regions of interest

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Funding

This study has received funding by the National Natural Science Foundation of China (ID: 81501441, 81601463, 81871410), Social Development Foundation of Jiangsu Province (BE2015605), Natural Science Foundation of Jiangsu Province (ID: BK20150109), Jiangsu Province Health and Family Planning Commission Youth Scientific Research Project (ID: Q201508), Six Talent Peaks Project of Jiangsu Province (ID: 2015-WSN-079), and Jiangsu Provincial Medical Youth Talent (ID: QNRC2016040).

Author information

Author notes

  1. Shunli Liu and Jian He contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China

    Shunli Liu, Jian He, Song Liu, Changfeng Ji & Zhengyang Zhou

  2. Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China

    Wenxian Guan

  3. Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China

    Ling Chen

  4. School of Electronic Science and Engineering, Nanjing University, Nanjing, 210046, China

    Yue Guan

  5. Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA

    Xiaofeng Yang

Authors
  1. Shunli Liu
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Corresponding authors

Correspondence to Xiaofeng Yang or Zhengyang Zhou.

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Guarantor

The scientific guarantor of this publication is Zhengyang Zhou, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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• retrospective

• diagnostic or prognostic study

• performed at one institution

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Liu, S., He, J., Liu, S. et al. Radiomics analysis using contrast-enhanced CT for preoperative prediction of occult peritoneal metastasis in advanced gastric cancer. Eur Radiol 30, 239–246 (2020). https://doi.org/10.1007/s00330-019-06368-5

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  • DOI: https://doi.org/10.1007/s00330-019-06368-5

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