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Gastroenterology:评估克罗恩病患者有无肠纤维化:基于机器学习的模型 完胜 放射科医生!

2021-02-22 MedSci原创 MedSci原创

纤维化是克罗恩病(Crohn病,CD)的严重并发症,约发生于一半的克罗恩患者。

纤维化是克罗恩病(Crohn病,CD)的严重并发症,约发生于一半的克罗恩患者。目前尚无可靠的方法评估克罗恩病患者的肠纤维化,因此,研究人员开发了一种基于计算机体层扫描(Computer-Tomography enterography,CTE)的放射组学模型(RM)来表征克罗恩病的肠纤维化。

这是一项回顾性的多中心研究,纳入了167例于2014年1月-2020年6月接受术前CTE和肠切除的克罗恩病患者,共212个肠道病灶(训练队列 98个;测试队列 114个)。肠纤维化的组织学分类为非轻度或中度-重度。在训练队列中,从静脉期CTE中提取了1454个放射学特征,并利用Logistic回归基于这些可重现的特征开发了基于机器学习的RM。该RM在独立的外部测试队列中得到了验证。通过受试者工作特征(ROC)曲线分析,将RM的诊断性能与两位放射科医师对CTE的目测判读进行比较。

RM在训练队列和验证队列中的表现

在训练队列中,RM区分中重度和非轻度肠纤维化的ROC曲线下面积为0.888(95%CI 0.818-0.957)。在测试队列中,RM在三个中心来源的患者队列中表现强劲,AUC值分别为0.816(95%CI 0.706-0.926)、0.724(0.526-0.923)和0.750(0.560-0.940)。

RM与放射科医生的判读表现对比

此外,在测试队列中,RM比任何一位放射科医生的目测判读都更准确(两位医生目测判读的AUC分别为0.554和0.598;均P<0.001)。决策曲线分析显示,与放射科医生相比,RM在预测肠纤维化方面提供了更好的净效益。

综上所述,基于CTE的RM可以比放射科医生更准确地识别克罗恩病患者的肠纤维化。

原始出处:

Li Xuehua,Liang Dong,Meng Jixin et al. Development and Validation of a Novel Computed-Tomography Enterography Radiomic Approach for Characterization of Intestinal Fibrosis in Crohn's Disease. Gastroenterology, 2021, 10.1053/j.gastro.2021.02.027.

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    2021-02-22 CHANGE

    梅斯里提供了很多疾病的模型计算公式,赞一个!

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