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Pancreatic ductal adenocarcinoma: a radiomics nomogram outperforms clinical model and TNM staging for survival estimation after curative resection

  • Computed Tomography
  • Published:
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Abstract

Objectives

To identify a CT-based radiomics nomogram for survival prediction in patients with resected pancreatic ductal adenocarcinoma (PDAC).

Methods

A total of 220 patients (training cohort n = 147; validation cohort n = 73) with PDAC were enrolled. A total of 300 radiomics features were extracted from CT images. And the least absolute shrinkage and selection operator algorithm were applied to select features and develop a radiomics score (Rad-score). The radiomics nomogram was constructed by multivariate regression analysis. Nomogram discrimination, calibration, and clinical usefulness were evaluated. The association of the Rad-score and recurrence pattern in PDAC was evaluated.

Results

The Rad-score was significantly associated with PDAC patient’s disease-free survival (DFS) and overall survival (OS) (both p < 0.001 in two cohorts). Incorporating the Rad-score into the radiomics nomogram resulted in better performance of the survival prediction than that of the clinical model and TNM staging system. In addition, the radiomics nomogram exhibited good discrimination, calibration, and clinical usefulness in both the training and validation cohorts. There was no association between the Rad-score and recurrence pattern.

Conclusions

The radiomics nomogram integrating the Rad-score and clinical data provided better prognostic prediction in resected PDAC patients, which may hold great potential for guiding personalized care for these patients. The Rad-score was not a predictor of the recurrence pattern in resected PDAC patients.

Key Points

• The Rad-score developed by CT radiomics features was significantly associated with PDAC patients’ prognosis.

• The radiomics nomogram integrating the Rad-score and clinical data has value to permit non-invasive, low-cost, and personalized evaluation of prognosis in PDAC patients.

• The radiomics nomogram outperformed clinical model and the TNM staging system in terms of survival estimation.

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Change history

  • 18 December 2020

    The Supplementary Information was missing in the online version.

Abbreviations

CA19.9:

Carbohydrate antigen 19-9

CI:

Confidence interval

C-index:

Harrell’s concordance-index

DCA:

Decision-curve analysis

DFS:

Disease-free survival

HER-2:

Human epidermal growth factor receptor-2

High/Low-RS:

High or low radiomics score

ICC:

Intraclass correlation coefficient

KM:

Kaplan-Meier

LASSO:

The least absolute shrinkage and selection operator

OS:

Overall survival

PDAC:

Pancreatic ductal adenocarcinoma

PNI:

Perineural invasion

Rad-score:

Radiomics score

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Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Tiansong Xie and Xuanyi Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Tiansong Xie, Menglei Li, Tong Tong & Zhengrong Zhou

  2. Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dongan Rd, Shanghai, 200032, People’s Republic of China

    Tiansong Xie, Menglei Li, Tong Tong & Zhengrong Zhou

  3. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Xuanyi Wang & Xiaoli Yu

  4. Department of Radiology, Minhang Branch of Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Zhengrong Zhou

Authors
  1. Tiansong Xie
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  3. Menglei Li
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  4. Tong Tong
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Correspondence to Zhengrong Zhou.

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The scientific guarantor of this publication is Zhengrong Zhou.

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

One of the authors has significant statistical expertise (Xuanyi Wang).

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

Methodology

•Retrospective.

•Diagnostic or prognostic study.

•Performed at one institution.

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Xie, T., Wang, X., Li, M. et al. Pancreatic ductal adenocarcinoma: a radiomics nomogram outperforms clinical model and TNM staging for survival estimation after curative resection. Eur Radiol 30, 2513–2524 (2020). https://doi.org/10.1007/s00330-019-06600-2

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  • DOI: https://doi.org/10.1007/s00330-019-06600-2

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