CT-based delta-radiomics for predicting pathological response to neoadjuvant immunochemotherapy in esophageal squamous cell carcinoma: a multicenter study

作者：Yuting Zheng, Peiyuan Mei, Mingliang Wang, Qinyue Luo, Hanting Li, Chengyu Ding, Kailu Zhang, Leqing Chen, Jin Gu, Yumin Li, Tingting Guo, Chi Zhang, Wenjian Yao, Li Wei, Yongde Liao, Xiaoyu Han, Heshui Shi · 发表于：BMC Medical Imaging · 年份：2024 · DOI：10.1186/s12880-024-01503-1 · 被引用次数：7 · 研究领域：Esophageal Cancer Research and Treatment、Radiomics and Machine Learning in Medical Imaging、Cancer Immunotherapy and Biomarkers

BACKGROUND: The study aimed to investigate the predictive value of delta-radiomics derived from computed tomography (CT) for pathological complete response (pCR) to neoadjuvant immunochemotherapy (NICT) among patients with esophageal squamous cell carcinoma (ESCC), helping clinicians determine whether to modify the neoadjuvant treatment strategy, proceed to surgery, or forgo surgery altogether. METHODS: A total of 140 ESCC patients from two institutions (Database 1 = 93; Database 2 = 47) who underwent NICT and surgery were retrospectively included in the study. The training set consisted of patients from Database 1, while the testing set included patients from Database 2. All patients underwent contrast-enhanced CT scans before the start of the treatment and prior to the operation. The delta-radiomics features were calculated as the relative net change of radiomics features between the two-time points. Feature selection was conducted using Pearson correlation analysis, intraclass correlation coefficients, and the fivefold cross-validation with least absolute shrinkage and selection analysis. Four models were established, comprising a clinical model, a pre-treatment radiomics model, a delta-radiomics model, and a mixed model. Area under the curve (AUC) and decision curve analysis were used to assess the performance and the clinical value of the models. RESULTS: Less than half of the tumors (40/140, 28.6%) showed pCR following NICT. The delta-radiomics model displayed AUC of 0....