Clinical-radiomics-based treatment decision support for KIT Exon 11 deletion in gastrointestinal stromal tumors: a multi-institutional retrospective study

Frontiers in Oncology

Oncology

Peng Zhang¹  Kaixiong Tao¹  Yuying Zhang²  Nan Diao³  Linxia Wu³  Yuting Lu³  Guina Ma³  Qian Li³  Xiaofei Yue³  Ping Han³  Yu Zhang³  Ling Ma⁴ 

[1] Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China;He Kang Corporate Management (SH) Co. Ltd., Shanghai, China;

关键词: radiomics;    CT;    gastrointestinal stromal tumor;    KIT exon 11;    nomogram;   

DOI  :  10.3389/fonc.2023.1193010

 received in 2023-03-28, accepted in 2023-07-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

Objectivegastrointestinal stromal tumors (GISTs) with KIT exon 11 deletions have more malignant clinical outcomes. A radiomics model was constructed for the preoperative prediction of KIT exon 11 deletion in GISTs.MethodsOverall, 126 patients with GISTs who underwent preoperative enhanced CT were included. GISTs were manually segmented using ITK-SNAP in the arterial phase (AP) and portal venous phase (PVP) images of enhanced CT. Features were extracted using Anaconda (version 4.2.0) with PyRadiomics. Radiomics models were constructed by LASSO. The clinical-radiomics model (combined model) was constructed by combining the clinical model with the best diagnostic effective radiomics model. ROC curves were used to compare the diagnostic effectiveness of radiomics model, clinical model, and combined model. Diagnostic effectiveness among radiomics model, clinical model and combine model were analyzed in external cohort (n=57). Statistics were carried out using R 3.6.1.ResultsThe Radscore showed favorable diagnostic efficacy. Among all radiomics models, the AP-PVP radiomics model exhibited excellent performance in the training cohort, with an AUC of 0.787 (95% CI: 0.687-0.866), which was verified in the test cohort (AUC=0.775, 95% CI: 0.608-0.895). Clinical features were also analyzed. Among the radiomics, clinical and combined models, the combined model showed favorable diagnostic efficacy in the training (AUC=0.863) and test cohorts (AUC=0.851). The combined model yielded the largest AUC of 0.829 (95% CI, 0.621–0.950) for the external validation of the combined model. GIST patients could be divided into high or low risk subgroups of recurrence and mortality by the Radscore.ConclusionThe radiomics models based on enhanced CT for predicting KIT exon 11 deletion mutations have good diagnostic performance.

【 授权许可】

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Copyright © 2023 Zhang, Yue, Zhang, Zhang, Wu, Diao, Ma, Lu, Ma, Tao, Li and Han