Prognostic Assessment in Patients With Primary Diffuse Large B‐Cell Lymphoma of the Central Nervous System Using MRI ‐Based Radiomics

作者：Jianpeng Liu, Jiaqi Tu, Bin Hu, Chao Li, Sirong Piao, Yucheng Lu, Anning Li, Tianling Ding, Ji Xiong, Fengping Zhu, Yuxin Li · 发表于：Journal of Magnetic Resonance Imaging · 年份：2024 · DOI：10.1002/jmri.29533 · 被引用次数：6 · 研究领域：CNS Lymphoma Diagnosis and Treatment、Glioma Diagnosis and Treatment、Lymphoma Diagnosis and Treatment

BACKGROUND: Primary central nervous system lymphoma (PCNSL) carries a poor prognosis. Radiomics may hold potential value in prognostic assessment. PURPOSE: To develop and validate an MRI-based radiomics model and combine it with clinical factors to assess progression-free survival (PFS) and overall survival (OS) of patients with PCNSL. STUDY TYPE: Retrospective and prospective. POPULATION: Three hundred seventy-nine patients (179 female, 53 ± 7 years) from 2014 to 2022. FIELD STRENGTH/SEQUENCE: T2/fluid-attenuated inversion recovery, contrast-enhanced T1WI and diffusion-weighted echo-planar imaging sequences on 3.0 T. ASSESSMENT: Radiomics features were extracted from enhanced tumor regions on preoperative multi-sequence MRI. Using a least absolute shrinkage and selection operator (LASSO) Cox regression model to select radiomic signatures in training cohort (N = 169). Cox proportional hazards models were constructed for clinical, radiomics, and combined models, with internal (N = 72) and external (N = 32) cohorts validating model performance. STATISTICAL TESTS: Chi-squared, Mann-Whitney, Kaplan-Meier, log-rank, LASSO, Cox, decision curve analysis, time-dependent Receiver Operating Characteristic, area under the curve (AUC), and likelihood ratio test. P-value <0.05 was considered significant. RESULTS: Follow-up duration was 28.79 ± 22.59 months (median: 25). High-risk patients, determined by the median radiomics score, showed significantly lower survival rates than low-risk pa...