Enhanced CT-Based Radiomics to Predict Micropapillary Pattern Within Lung Invasive Adenocarcinoma

Yunyu Xu; Wenbin Ji; Liqiao Hou; Shuangxiang Lin; Yangyang Shi; Chao Zhou; Yinnan Meng; Wei Wang; Xiaofeng Chen; Meihao Wang; Haihua Yang

doi:10.3389/fonc.2021.704994

Enhanced CT-Based Radiomics to Predict Micropapillary Pattern Within Lung Invasive Adenocarcinoma

Front Oncol. 2021 Aug 27:11:704994. doi: 10.3389/fonc.2021.704994. eCollection 2021.

Authors

Yunyu Xu^{1

2}, Wenbin Ji³, Liqiao Hou¹, Shuangxiang Lin³, Yangyang Shi⁴, Chao Zhou¹, Yinnan Meng¹, Wei Wang¹, Xiaofeng Chen⁵, Meihao Wang², Haihua Yang¹

Affiliations

¹ Key Laboratory of Radiation Oncology of Taizhou, Radiation Oncology Institute of Enze Medical Health Academy, Department of Radiation Oncology, Taizhou Hospital Affiliated to Wenzhou Medical University, Taizhou, China.
² Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
³ Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.
⁴ Department of Radiation Oncology, University of Arizona, Tucson, AZ, United States.
⁵ Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IU, United States.

Abstract

Objective: We aimed to investigate whether enhanced CT-based radiomics can predict micropapillary pattern (MPP) of lung invasive adenocarcinoma (IAC) in the pre-op phase and to develop an individual diagnostic predictive model for MPP in IAC.

Methods: 170 patients who underwent complete resection for pathologically confirmed lung IAC were included in our study. Of these 121 were used as a training cohort and the other 49 as a test cohort. Clinical features and enhanced CT images were collected and assessed. Quantitative CT analysis was performed based on feature types including first order, shape, gray-level co-occurrence matrix-based, gray-level size zone matrix-based, gray-level run length matrix-based, gray-level dependence matrix-based, neighboring gray tone difference matrix-based features and transform types including Log, wavelet and local binary pattern. Receiver operating characteristic (ROC) and area under the curve (AUC) were used to value the ability to identify the lung IAC with MPP using these characteristics.

Results: Using quantitative CT analysis, one thousand three hundred and seventeen radiomics features were deciphered from R (https://www.r-project.org/). Then these radiomic features were decreased to 14 features after dimension reduction using the least absolute shrinkage and selection operator (LASSO) method in R. After correlation analysis, 5 key features were obtained and used as signatures for predicting MPP within IAC. The individualized prediction model which included age, smoking, family tumor history and radiomics signature had better identification (AUC=0.739) in comparison with the model consisting only of radiomics features (AUC=0.722). DeLong test showed that the difference in AUC between the two models was statistically significant (P<0.01). Compared with the simple radiomics model, the more comprehensive individual prediction model has better prediction performance.

Conclusion: The use of radiomics approach is of great value in the diagnosis of tumors by non-invasive means. The individualized prediction model in the study, when incorporated with age, smoking and radiomics signature, had effective predictive performance of lung IAC with MPP lesions. The combination of imaging features and clinical features can provide additional diagnostic value to identify the micropapillary pattern in IAC and can affect clinical diagnosis and treatment.

Keywords: computer tomography; early diagnosis of cancer; lung adenocarcinoma; micropapillary pattern; radiomics.