[1]陈炜越,林桂涵,陈勇军,等.增强 MRI 的影像组学列线图预测中晚期肝细胞癌患者首次TACE的疗效[J].介入放射学杂志,2025,34(10):1081-1088.[doi:10.3969/j.issn.1008-794X.2025.10.008]
　CHEN Weiyue,LIN Guihan,CHEN Yongjun,et al.Application of enhanced MRI-based radiomics nomogram in predicting the efficacy of initial TACE in patients with intermediate to advanced hepatocellular carcinoma[J].J Intervent Med,2025,34(10):1081-1088.[doi:10.3969/j.issn.1008-794X.2025.10.008]
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增强 MRI 的影像组学列线图预测中晚期肝细胞癌患者首次TACE的疗效()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
34
期数:
2025年10
页码:
1081-1088
栏目:
肿瘤介入
出版日期:
2025-10-25

文章信息/Info

Title:
Application of enhanced MRI-based radiomics nomogram in predicting the efficacy of initial TACE in patients with intermediate to advanced hepatocellular carcinoma
文章编号:
1008-794X(2025)-010-1081-08
作者:
陈炜越;  林桂涵;  陈勇军;  施昌盛;  涂建飞;  纪建松
323000 浙江丽水 温州医科大学附属第五医院放射科 全省影像与介入医学重点实验室(陈炜越、林桂涵、涂建飞、纪建松); 丽水市人民医院介入科(陈勇军); 瑞安市人民医院介入科(施昌盛)
Author(s):
CHEN Weiyue; LIN Guihan; CHEN Yongjun; SHI Changsheng; TU Jianfei; JI Jiansong.
Department of Radiology,Affiliated Fifth Hospital of Wenzhou Medical University,Zhejiang Key Laboratory of Imaging and Interventional Medicine,Lishui,Zhejiang Province 323000,China
关键词:
肝细胞癌;  影像组学;  化疗栓塞;  磁共振成像
DOI:
10.3969/j.issn.1008-794X.2025.10.008
文献标志码:
A
摘要:
目的 探讨增强MRI的影像组学列线图预测中晚期肝细胞癌(HCC)患者首次肝动脉化疗栓塞术(TACE)的疗效。方法 纳入2019年1月至2024年3月在温州医科大学附属第五医院(中心1)、2021年7月至2023年6月在丽水市人民医院(中心2)和2022年1月至2024年1月在瑞安市人民医院(中心3)介入科行TACE治疗的中晚期肝癌(CNLC Ⅱb～Ⅲb)患者。将134例来自中心1的患者以7:3比例随机分为训练集94例和内部验证集40例; 61例来自中心2和中心3的患者作为外部验证集。根据改良实体瘤疗效评价标准评估首次TACE 术后的早期疗效,将其分为有效组和无效组。对增强MRI的动脉期、门脉期、平衡期图像勾画肿瘤轮廓并提取其影像组学特征。基于降维后的特征建立逻辑回归、支持向量机、轻量级梯度提升机和多层感知器模型。运用单因素和多因素logistic回归对独立预测因素进行筛选,并联合最优影像组学评分建立列线图。受试者操作特征曲线下面积(AUC)评估模型性能,并通过决策曲线分析计算净获益。结果 经筛选获得了9个关键影像组学特征。轻量级梯度提升机模型表现出良好的预测性能,训练集、内部验证集和外部验证集的AUC分别为0.909、0.836、0.783,选择其作为最优影像组学模型。基于AFP水平、瘤周强化和最优影像组学评分构建的列线图可进一步提升性能,其在训练集、内部验证集和外部验证集的AUC分别为0.962、0.890、0.821。决策曲线分析表明,该模型可为患者带来更高的净获益。结论 增强MRI影像组学联合AFP水平和瘤周强化构建的列线图可有效预测中晚期HCC患者首次TACE的疗效。

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(收稿日期:2025-01-22)
(本文编辑:新 宇)

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备注/Memo

备注/Memo:
通信作者: 纪建松 E-mail:jjstcty@sina.com
更新日期/Last Update: 2025-10-25