Development of a computed tomography-based radiomics nomogram for prediction of transarterial chemoembolization refractoriness in hepatocellular carcinoma

作     者：Xiang-Ke Niu Xiao-Feng He 

作者机构：Department of Interventional RadiologyNanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Interventional RadiologyAffiliated Hospital of Chengdu UniversityChengdu 610081Sichuan ProvinceChina 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2021年第27卷第2期

页      面：189-207页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Health and Family Planning Commission of Sichuan Province China No.17PJ430 and No.18PJ150 

主　　题：Hepatocellular carcinoma Transarterial chemoembolization Refractoriness Radiomics Nomogram Computed tomography 

摘      要：BACKGROUND Some patients with hepatocellular carcinoma(HCC)are more likely to experience disease progression despite continuous transarterial chemoembolization(TACE),which is called TACE *** present,it is still difficult to predict TACE refractoriness,although some models/scoring systems have been *** present,radiological-based radiomics models have been successfully applied to predict cancer patient *** To develop and validate a computed tomography(CT)-based radiomics nomogram for the pre-treatment prediction of TACE *** This retrospective study consisted of a training dataset(n=137)and an external validation dataset(n=81)of patients with clinically/pathologically confirmed HCC who underwent repeated TACE from March 2009 to March *** features were retrospectively extracted from preoperative CT images of the arterial *** pre-treatment radiomics signature was generated using least absolute shrinkage and selection operator Cox regression analysis.A CT-based radiomics nomogram incorporating clinical risk factors and the radiomics signature was built and verified by calibration curve and decision curve *** usefulness of the CT-based radiomics nomogram was assessed by Kaplan-Meier curve *** used the concordance index to conduct head-to-head comparisons of the radiomics nomogram with the other four models(Assessment for Retreatment with Transarterial Chemoembolization score;α-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh,and Response score;CT-based radiomics signature;and clinical model).All analyses were conducted according to the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis *** The median duration of follow-up was 61.3 mo(interquartile range,25.5-69.3 mo)for the training cohort and 67.1 mo(interquartile range,32.4-71.3 mo)for the validation *** median number of TACE sessions was 4(range,3-7)in both cohorts.E