TY - JOUR
T1 - A radiomics-based nomogram for the preoperative prediction of posthepatectomy liver failure in patients with hepatocellular carcinoma
AU - Cai, Wei
AU - He, Baochun
AU - Hu, Min
AU - Zhang, Wenyu
AU - Xiao, Deqiang
AU - Yu, Hao
AU - Song, Qi
AU - Xiang, Nan
AU - Yang, Jian
AU - He, Songsheng
AU - Huang, Yaohuan
AU - Huang, Wenjie
AU - Jia, Fucang
AU - Fang, Chihua
N1 - Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2019/3
Y1 - 2019/3
N2 - Objectives: To develop and validate a radiomics-based nomogram for the preoperative prediction of posthepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods: One hundred twelve consecutive HCC patients who underwent hepatectomy were included in the study pool (training cohort: n = 80, validation cohort: n = 32), and another 13 patients were included in a pilot prospective analysis. A total of 713 radiomics features were extracted from portal-phase computed tomography (CT) images. A logistic regression was used to construct a radiomics score (Rad-score). Then a nomogram, including Rad-score and other risk factors, was built with a multivariate logistic regression model. The discrimination, calibration and clinical utility of nomogram were evaluated. Results: The Rad-score could predict PHLF with an AUC of 0.822 (95% CI, 0.726–0.917) in the training cohort and of 0.762 (95% CI, 0.576–0.948) in the validation cohort; however, the approach could not completely outmatch the existing methods (CP [Child-Pugh], MELD [Model of End Stage Liver Disease], ALBI [albumin-bilirubin]). The individual predictive nomogram that included the Rad-score, MELD and performance status (PS) showed better discrimination with an AUC of 0.864 (95% CI, 0.786–0.942), which was higher than the AUCs of the conventional methods (nomogram vs CP, MELD, and ALBI at P < 0.001, P < 0.005, and P < 0.005, respectively). In the validation cohort, the nomogram discrimination was also superior to those of the other three methods (AUC: 0.896; 95% CI, 0.774–1.000). The calibration curves showed good agreement in both cohorts, and the decision curve analysis of the entire cohort revealed that the nomogram was clinically useful. A pilot prospective analysis showed that the radiomics nomogram could predict PHLF with an AUC of 0.833 (95% CI, 0.591–1.000). Conclusions: A nomogram based on the Rad-score, MELD, and PS can predict PHLF.
AB - Objectives: To develop and validate a radiomics-based nomogram for the preoperative prediction of posthepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). Methods: One hundred twelve consecutive HCC patients who underwent hepatectomy were included in the study pool (training cohort: n = 80, validation cohort: n = 32), and another 13 patients were included in a pilot prospective analysis. A total of 713 radiomics features were extracted from portal-phase computed tomography (CT) images. A logistic regression was used to construct a radiomics score (Rad-score). Then a nomogram, including Rad-score and other risk factors, was built with a multivariate logistic regression model. The discrimination, calibration and clinical utility of nomogram were evaluated. Results: The Rad-score could predict PHLF with an AUC of 0.822 (95% CI, 0.726–0.917) in the training cohort and of 0.762 (95% CI, 0.576–0.948) in the validation cohort; however, the approach could not completely outmatch the existing methods (CP [Child-Pugh], MELD [Model of End Stage Liver Disease], ALBI [albumin-bilirubin]). The individual predictive nomogram that included the Rad-score, MELD and performance status (PS) showed better discrimination with an AUC of 0.864 (95% CI, 0.786–0.942), which was higher than the AUCs of the conventional methods (nomogram vs CP, MELD, and ALBI at P < 0.001, P < 0.005, and P < 0.005, respectively). In the validation cohort, the nomogram discrimination was also superior to those of the other three methods (AUC: 0.896; 95% CI, 0.774–1.000). The calibration curves showed good agreement in both cohorts, and the decision curve analysis of the entire cohort revealed that the nomogram was clinically useful. A pilot prospective analysis showed that the radiomics nomogram could predict PHLF with an AUC of 0.833 (95% CI, 0.591–1.000). Conclusions: A nomogram based on the Rad-score, MELD, and PS can predict PHLF.
KW - Hepatocellular carcinoma
KW - Liver failure
KW - Nomogram
KW - Radiomics
UR - http://www.scopus.com/inward/record.url?scp=85057173558&partnerID=8YFLogxK
U2 - 10.1016/j.suronc.2018.11.013
DO - 10.1016/j.suronc.2018.11.013
M3 - Article
C2 - 30851917
AN - SCOPUS:85057173558
SN - 0960-7404
VL - 28
SP - 78
EP - 85
JO - Surgical Oncology
JF - Surgical Oncology
ER -