Skip to main content
Erschienen in: Abdominal Radiology 2/2024

13.11.2023 | Pancreas

Preoperative evaluating early recurrence in resectable pancreatic ductal adenocarcinoma by using CT radiomics

verfasst von: Gang Wang, Weijie Lei, Shaofeng Duan, Aihong Cao, Hongyuan Shi

Erschienen in: Abdominal Radiology | Ausgabe 2/2024

Einloggen, um Zugang zu erhalten

Abstract

Objective

To investigate the feasibility of a radiomics model based on contrast-enhanced CT for preoperatively predicting early recurrence after curative resection in patients with resectable pancreatic ductal adenocarcinoma (PDAC).

Methods

One hundred and eighty-six patients with resectable PDAC who underwent curative resection were included and allocated to training set (131 patients) and validation set (55 patients). Radiomics features were extracted from arterial phase and portal venous phase images. The Mann-Whitney U test and least absolute shrinkage and selection operator (LASSO) regression were used for feature selection and radiomics signature construction. The radiomics model based on radiomics signature and clinical features was developed by the multivariate logistic regression analysis. Performance of the radiomics model was investigated by the area under the receiver operating characteristic (ROC) curve.

Results

The radiomics signature, consisting of three arterial phase and three venous phase features, showed optimal prediction performance for early recurrence in both training (AUC = 0.73) and validation sets (AUC = 0.66). Multivariate logistic analysis identified the radiomics signature (OR, 2.58; 95% CI 2.36–3.17; p = 0.002) and clinical stage (OR, 1.60; 95% CI 1.15–2.30; p = 0.007) as independent predictors. The AUC values for risk evaluation of early recurrence using the radiomics model incorporating clinical stage were 0.80 (training set) and 0.75 (validation set).

Conclusion

The radiomics-based model integrating with clinical stage can predict early recurrence after upfront surgery in patients with resectable PDAC.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73:17-48.CrossRefPubMed Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73:17-48.CrossRefPubMed
2.
Zurück zum Zitat Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019;20:1493-505.CrossRefPubMedPubMedCentral Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 2019;20:1493-505.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Merkow RP, Bilimoria KY, Tomlinson JS, et al. Postoperative complications reduce adjuvant chemotherapy use in resectable pancreatic cancer. Ann Surg 2014;260:372-7.CrossRefPubMed Merkow RP, Bilimoria KY, Tomlinson JS, et al. Postoperative complications reduce adjuvant chemotherapy use in resectable pancreatic cancer. Ann Surg 2014;260:372-7.CrossRefPubMed
4.
Zurück zum Zitat Khorana AA, Mangu PB, Berlin J, et al. Potentially curable pancreatic cancer: American society of clinical oncology clinical practice guideline. J Clin Oncol 2016;34:2541–55.CrossRefPubMed Khorana AA, Mangu PB, Berlin J, et al. Potentially curable pancreatic cancer: American society of clinical oncology clinical practice guideline. J Clin Oncol 2016;34:2541–55.CrossRefPubMed
5.
Zurück zum Zitat Groot VP, Rezaee N, Wu W, et al. Patterns, timing, and predictors of recurrence following pancreatectomy for pancreatic ductal adenocarcinoma. Ann Surg 2018;267:936-45.CrossRefPubMed Groot VP, Rezaee N, Wu W, et al. Patterns, timing, and predictors of recurrence following pancreatectomy for pancreatic ductal adenocarcinoma. Ann Surg 2018;267:936-45.CrossRefPubMed
6.
Zurück zum Zitat Groot VP, Gemenetzis G, Blair AB, et al. Defining and predicting early recurrence in 957 patients with resected pancreatic ductal adenocarcinoma. Ann Surg 2019;269:1154-62.CrossRefPubMed Groot VP, Gemenetzis G, Blair AB, et al. Defining and predicting early recurrence in 957 patients with resected pancreatic ductal adenocarcinoma. Ann Surg 2019;269:1154-62.CrossRefPubMed
7.
Zurück zum Zitat Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N Engl J Med 2018;379:2395-406.CrossRefPubMed Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N Engl J Med 2018;379:2395-406.CrossRefPubMed
8.
Zurück zum Zitat Khorana AA, Mangu PB, Berlin J, et al. Potentially curable pancreatic cancer: American society of clinical oncology clinical practice guideline update. J Clin Oncol 2017;35:2324-8.CrossRefPubMed Khorana AA, Mangu PB, Berlin J, et al. Potentially curable pancreatic cancer: American society of clinical oncology clinical practice guideline update. J Clin Oncol 2017;35:2324-8.CrossRefPubMed
9.
Zurück zum Zitat National Comprehensive Cancer Network. Pancreatic Adenocarcinoma, 2021. NCCN Clinical Practice Guidelines in Oncology Web site. National Comprehensive Cancer Network. Pancreatic Adenocarcinoma, 2021. NCCN Clinical Practice Guidelines in Oncology Web site.
10.
Zurück zum Zitat Al-Hawary MM, Francis IR, Chari ST, et al. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the society of abdominal radiology and the American pancreatic association. Radiology 2014;270:248-60.CrossRefPubMed Al-Hawary MM, Francis IR, Chari ST, et al. Pancreatic ductal adenocarcinoma radiology reporting template: consensus statement of the society of abdominal radiology and the American pancreatic association. Radiology 2014;270:248-60.CrossRefPubMed
11.
Zurück zum Zitat Springfeld, C., Neoptolemos, J. P. The role of neoadjuvant therapy for resectable pancreatic cancer remains uncertain. Nat Rev Clin Oncol 2022;5:285-6.CrossRef Springfeld, C., Neoptolemos, J. P. The role of neoadjuvant therapy for resectable pancreatic cancer remains uncertain. Nat Rev Clin Oncol 2022;5:285-6.CrossRef
12.
Zurück zum Zitat Aerts HJ, Velazquez ER, Leijenaar RT, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 2014;5:4006.CrossRefPubMed Aerts HJ, Velazquez ER, Leijenaar RT, et al. Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 2014;5:4006.CrossRefPubMed
13.
Zurück zum Zitat Bi WL, Hosny A, Schabath MB, et al. Artificial intelligence in cancer imaging: clinical challenges and applications. CA Cancer J Clin 2019;69:127-57.CrossRefPubMedPubMedCentral Bi WL, Hosny A, Schabath MB, et al. Artificial intelligence in cancer imaging: clinical challenges and applications. CA Cancer J Clin 2019;69:127-57.CrossRefPubMedPubMedCentral
14.
15.
Zurück zum Zitat Sauerbrei E, Royston P, Binder H, Selection of important variables and determination of functional form for continuous predictors in multivariable model building. Stat Med 2007;26:5512-28.CrossRefPubMed Sauerbrei E, Royston P, Binder H, Selection of important variables and determination of functional form for continuous predictors in multivariable model building. Stat Med 2007;26:5512-28.CrossRefPubMed
16.
Zurück zum Zitat He M, Chen X, Wels M, et al. Computed tomography-based radiomics evaluation of postoperative local recurrence of pancreatic ductal adenocarcinoma. Acad Radiol 2023;30:680-8.CrossRefPubMed He M, Chen X, Wels M, et al. Computed tomography-based radiomics evaluation of postoperative local recurrence of pancreatic ductal adenocarcinoma. Acad Radiol 2023;30:680-8.CrossRefPubMed
17.
Zurück zum Zitat Adamu M, Nitschke P, Petrov P, et al. Validation of prognostic risk scores for patients undergoing resection for pancreatic cancer. Pancreatology 2018;18:585-91.CrossRefPubMed Adamu M, Nitschke P, Petrov P, et al. Validation of prognostic risk scores for patients undergoing resection for pancreatic cancer. Pancreatology 2018;18:585-91.CrossRefPubMed
18.
Zurück zum Zitat Tanaka M, Mihaljevic AL, Probst P, et al. Meta-analysis of recurrence pattern after resection for pancreatic cancer. Br J Surg. 2019;106:1590-1601.CrossRefPubMed Tanaka M, Mihaljevic AL, Probst P, et al. Meta-analysis of recurrence pattern after resection for pancreatic cancer. Br J Surg. 2019;106:1590-1601.CrossRefPubMed
19.
Zurück zum Zitat Jones RP, Psarelli EE, JacksonR, et al. Patterns of recurrence after resection of pancreatic ductal adenocarcinoma: a secondary analysis of the ESPAC-4 randomized adjuvant chemotherapy trial. JAMA Surg. 2019;154:1038-48.CrossRefPubMedPubMedCentral Jones RP, Psarelli EE, JacksonR, et al. Patterns of recurrence after resection of pancreatic ductal adenocarcinoma: a secondary analysis of the ESPAC-4 randomized adjuvant chemotherapy trial. JAMA Surg. 2019;154:1038-48.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Karamitopoulou E, Wenning AS, Acharjee A, et al. Spatially restricted tumour-associated and host-associated immune drivers correlate with the recurrence sites of pancreatic cancer. Gut. 2023;72:1523-33.CrossRefPubMed Karamitopoulou E, Wenning AS, Acharjee A, et al. Spatially restricted tumour-associated and host-associated immune drivers correlate with the recurrence sites of pancreatic cancer. Gut. 2023;72:1523-33.CrossRefPubMed
21.
Zurück zum Zitat Kim JH, Park SH, Yu ES, et al. Visually isoattenuating pancreatic adenocarcinoma at dynamic-enhanced CT: frequency, clinical and pathologic characteristics, and diagnosis at imaging examinations. Radiology 2010;257:87-96.CrossRefPubMed Kim JH, Park SH, Yu ES, et al. Visually isoattenuating pancreatic adenocarcinoma at dynamic-enhanced CT: frequency, clinical and pathologic characteristics, and diagnosis at imaging examinations. Radiology 2010;257:87-96.CrossRefPubMed
22.
Zurück zum Zitat Prokesch RW, Chow LC, Beaulieu CF. et al. Isoattenuating pancreatic adenocarcinoma at multi-detector row CT: secondary signs. Radiology 2002;224:764-8.CrossRefPubMed Prokesch RW, Chow LC, Beaulieu CF. et al. Isoattenuating pancreatic adenocarcinoma at multi-detector row CT: secondary signs. Radiology 2002;224:764-8.CrossRefPubMed
23.
Zurück zum Zitat Ishigami K, Yoshimitsu K, Irie H, et al. Diagnostic value of the delayed phase image for iso-attenuating pancreatic carcinomas in the pancreatic parenchymal phase on multidetector computed tomography. Eur J Radiol 2009;69:139-46.CrossRefPubMed Ishigami K, Yoshimitsu K, Irie H, et al. Diagnostic value of the delayed phase image for iso-attenuating pancreatic carcinomas in the pancreatic parenchymal phase on multidetector computed tomography. Eur J Radiol 2009;69:139-46.CrossRefPubMed
24.
Zurück zum Zitat Sohn TA, Yeo CJ, Cameron JL, et al. Resected adenocarcinoma of the pancreas--616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 2000;4:567-9.CrossRefPubMed Sohn TA, Yeo CJ, Cameron JL, et al. Resected adenocarcinoma of the pancreas--616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 2000;4:567-9.CrossRefPubMed
25.
Zurück zum Zitat Shi H, Wei Y, Cheng S, et al. Survival prediction after upfront surgery in patients with pancreatic ductal adenocarcinoma: Radiomic, clinic-pathologic and body composition analysis. Pancreatology. 2021;21:731-7.CrossRefPubMed Shi H, Wei Y, Cheng S, et al. Survival prediction after upfront surgery in patients with pancreatic ductal adenocarcinoma: Radiomic, clinic-pathologic and body composition analysis. Pancreatology. 2021;21:731-7.CrossRefPubMed
26.
Zurück zum Zitat Kulkarni A, Carrion-Martinez I, Jiang NN, et al. Hypovascular pancreas head adenocarcinoma: CT texture analysis for assessment of resection margin status and high-risk features. Eur Radiol 2020;30:2853-60.CrossRefPubMed Kulkarni A, Carrion-Martinez I, Jiang NN, et al. Hypovascular pancreas head adenocarcinoma: CT texture analysis for assessment of resection margin status and high-risk features. Eur Radiol 2020;30:2853-60.CrossRefPubMed
27.
Zurück zum Zitat Chu LC, S. Park, S. Kawamoto, et al. Utility of CT radiomics features in differentiation of pancreatic ductal adenocarcinoma from normal pancreatic tissue. Am. J. Roentgenol 2019;213:349-57.CrossRef Chu LC, S. Park, S. Kawamoto, et al. Utility of CT radiomics features in differentiation of pancreatic ductal adenocarcinoma from normal pancreatic tissue. Am. J. Roentgenol 2019;213:349-57.CrossRef
28.
Zurück zum Zitat Kim DW, Lee SS, Kim SO, et al. Estimating recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma by using pancreatic CT: development and validation of a risk score. Radiology 2020;296:541-51.CrossRefPubMed Kim DW, Lee SS, Kim SO, et al. Estimating recurrence after upfront surgery in patients with resectable pancreatic ductal adenocarcinoma by using pancreatic CT: development and validation of a risk score. Radiology 2020;296:541-51.CrossRefPubMed
29.
Zurück zum Zitat Tang TY, Li X, Zhang Q, et al. Development of a novel multiparametric MRI radiomic nomogram for preoperative evaluation of early recurrence in resectable pancreatic cancer. J Magn Reson Imaging 2020;52:231-45.CrossRefPubMed Tang TY, Li X, Zhang Q, et al. Development of a novel multiparametric MRI radiomic nomogram for preoperative evaluation of early recurrence in resectable pancreatic cancer. J Magn Reson Imaging 2020;52:231-45.CrossRefPubMed
30.
Zurück zum Zitat Guo SW, Shen J, Gao JH, et al. A preoperative risk model for early recurrence after radical resection may facilitate initial treatment decisions concerning the use of neoadjuvant therapy for patients with pancreatic ductal adenocarcinoma. Surgery 2020;168:1003-14.CrossRefPubMed Guo SW, Shen J, Gao JH, et al. A preoperative risk model for early recurrence after radical resection may facilitate initial treatment decisions concerning the use of neoadjuvant therapy for patients with pancreatic ductal adenocarcinoma. Surgery 2020;168:1003-14.CrossRefPubMed
31.
Zurück zum Zitat Imamura M, Nagayama M, Kyuno D, et al. Perioperative predictors of early recurrence for resectable and borderline-resectable pancreatic cancer. Cancers (Basel) 2021;13:2285CrossRefPubMed Imamura M, Nagayama M, Kyuno D, et al. Perioperative predictors of early recurrence for resectable and borderline-resectable pancreatic cancer. Cancers (Basel) 2021;13:2285CrossRefPubMed
Metadaten
Titel
Preoperative evaluating early recurrence in resectable pancreatic ductal adenocarcinoma by using CT radiomics
verfasst von
Gang Wang
Weijie Lei
Shaofeng Duan
Aihong Cao
Hongyuan Shi
Publikationsdatum
13.11.2023
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 2/2024
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-023-04074-x

Weitere Artikel der Ausgabe 2/2024

Abdominal Radiology 2/2024 Zur Ausgabe

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärztinnen und Psychotherapeuten.

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.