Development and Validation of a Radiomics Nomogram for Preoperative Prediction of Lymph Node Metastasis in Colorectal Cancer

作者：Yanqi Huang, Changhong Liang, Lan He, Jie Tian, Cuishan Liang, Xin Chen, Zelan Ma, Zaiyi Liu · 发表于：Journal of Clinical Oncology · 年份：2016 · DOI：10.1200/jco.2015.65.9128 · 被引用次数：1898 · 研究领域：Colorectal Cancer Surgical Treatments、Radiomics and Machine Learning in Medical Imaging、Colorectal and Anal Carcinomas

PURPOSE: To develop and validate a radiomics nomogram for preoperative prediction of lymph node (LN) metastasis in patients with colorectal cancer (CRC). PATIENTS AND METHODS: The prediction model was developed in a primary cohort that consisted of 326 patients with clinicopathologically confirmed CRC, and data was gathered from January 2007 to April 2010. Radiomic features were extracted from portal venous-phase computed tomography (CT) of CRC. Lasso regression model was used for data dimension reduction, feature selection, and radiomics signature building. Multivariable logistic regression analysis was used to develop the predicting model, we incorporated the radiomics signature, CT-reported LN status, and independent clinicopathologic risk factors, and this was presented with a radiomics nomogram. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed. An independent validation cohort contained 200 consecutive patients from May 2010 to December 2011. RESULTS: The radiomics signature, which consisted of 24 selected features, was significantly associated with LN status (P < .001 for both primary and validation cohorts). Predictors contained in the individualized prediction nomogram included the radiomics signature, CT-reported LN status, and carcinoembryonic antigen level. Addition of histologic grade to the nomogram failed to show incremental prognostic value. The model showed g...