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Radiomics nomograms based on R2* mapping and clinical biomarkers for staging of liver fibrosis in patients with chronic hepatitis B: a single-center retrospective study

  • Magnetic Resonance
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Abstract

Objectives

To investigate the value of R2* mapping–based radiomics nomograms in staging liver fibrosis in patients with chronic hepatitis B.

Methods

Between January 2020 and December 2020, 151 patients with chronic hepatitis B were randomly divided into training (n = 103) and validation (n = 48) cohorts. From January to February 2021, 58 patients were included in a test cohort. Radiomics features were selected using the interclass correlation coefficient and least absolute shrinkage and selection operator method. Three radiomics nomograms, combining the radiomics score (Radscore) derived from R2* mapping and clinical variables, were used for staging significant and advanced fibrosis, and cirrhosis. Performance of the model was evaluated using the AUC. The utility and clinical benefits were evaluated using the continuous net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA).

Results

The Radscore calculated by 12 radiomics features and independent factors (laminin and platelet) of advanced fibrosis were used to construct the radiomics nomograms. In the test cohort, the AUCs of the radiomics nomograms for staging significant fibrosis, advanced fibrosis, and cirrhosis were 0.738 (95% confidence interval [CI]: 0.604–0.872), 0.879 (95% CI: 0.779–0.98), and 0.952 (95% CI: 0.878–1), respectively. NRI, IDI, and DCA confirmed that radiomics nomograms demonstrated varying degrees of clinical benefit and improvement for advanced fibrosis and cirrhosis, but not for significant fibrosis.

Conclusions

Radiomics nomograms combined with R2* mapping–based Radscore, laminin, and platelet have value in staging advanced fibrosis and cirrhosis but limited value for staging significant fibrosis.

Key Points

• Laminin and platelets were independent predictors of advanced fibrosis.

• Radiomics analysis based on R2* mapping was beneficial for evaluating advanced fibrosis and cirrhosis.

• It was difficult to distinguish significant fibrosis using a radiomics nomogram, which is possibly due to the complex pathological microenvironment of chronic liver diseases.

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Abbreviations

AIC:

Akaike’s information criterion

ALB:

Albumin

ALP:

Alkaline phosphatase

ALT:

Alanine aminotransferase

APRI:

Aminotransferase-to-platelet ratio index

AST:

Aspartate aminotransferase

CHE:

Cholinesterase

CI:

Confidence interval

CIV:

Type IV collagen

CLD:

Chronic liver diseases

DB:

Direct bilirubin

DCA:

Decision curve analysis

FIB-4:

Fibrosis-4 index

GGT:

γ-Glutamyl transpeptidase

GLO:

Globulin

HA:

Hyaluronic acid

HGB:

Hemoglobin

ICC:

interclass correlation coefficient

ID:

Indirect bilirubin

IDEAL-IQ:

Iterative decomposition of water and fat with echo asymmetry and least squares estimation

IDI:

Integrated discrimination improvement

IVIM:

Intravoxel incoherent motion

LASSO:

Least absolute shrinkage and selection operator

LDH:

Lactate dehydrogenase

LN:

Laminin

LYM:

Lymphocytes

MAO:

Monoamine oxidase

NEUT:

Neutrophil count

NRI:

Net reclassification index

PA:

Prealbumin

PDFF:

Proton density fat fraction

PIIIP:

Type III procollagen N peptide

PLT:

Platelets

Radscore:

Radiomic score

RBC:

Red blood cells

ROC:

Receiver operator characteristic

TB:

Total bilirubin

TBA:

Total bile acid,

TP:

Total protein

VIF:

Variance inflation factor

WBC:

White blood cell

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Funding

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

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Author notes

  1. Die Zhang and Yi Cao contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Radiology, National Clinical Research Center for Infectious Disease, Shenzhen Third People’s Hospital, The Second Affiliated Hospital, School of Medicine Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, 518000, Guangdong, People’s Republic of China

    Die Zhang, Yi Cao, Yi Sun, Cheng Peng, Jing Zhao, Xiaohui Bao, Lifei Wang & Chen Zhang

  2. Department of Pathology, National Clinical Research Center for Infectious Disease, Shenzhen Third People’s Hospital, The Second Affiliated Hospital, School of Medicine Southern University of Science and Technology, 29 Bulan Road, Longgang District, Shenzhen, 518000, Guangdong, People’s Republic of China

    Xia Zhao

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Zhang, D., Cao, Y., Sun, Y. et al. Radiomics nomograms based on R2* mapping and clinical biomarkers for staging of liver fibrosis in patients with chronic hepatitis B: a single-center retrospective study. Eur Radiol 33, 1653–1667 (2023). https://doi.org/10.1007/s00330-022-09137-z

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