OBJECTIVES To accurately identify the relationship between a portal radiomics score (rad-score) and pathologic superior mesenteric vein (SMV) resection margin and to evaluate the diagnostic performance in patients with pancreatic head cancer. MATERIALS AND METHODS A total of 181 patients with postoperatively and pathologically confirmed pancreatic head cancer who underwent multislice computed tomography within one month of resection between January 2016 and December 2018 were retrospectively investigated. For each patient, 1029 radiomics features of the portal phase were extracted, which were reduced using the least absolute shrinkage and selection operator (LASSO) logistic regression algorithm. Multivariate logistic regression models were used to analyze the association between the portal rad-score and SMV resection margin. RESULTS Patients with negative (R0) and positive (R1) margins accounted for 70.17% (127) and 29.83% (54) of the cohort, respectively. The rad-score was significantly associated with the SMV resection margin status (p < 0.05). Multivariate analyses confirmed a significant and independent association between the portal rad-score and SMV resection margin (OR 4.62; 95% CI 2.19-9.76; p < 0.0001). The portal rad-score had high accuracy (area under the curve = 0.750). The best cut point based on maximizing the sum of sensitivity and specificity was - 0.741 (sensitivity = 64.8%; specificity = 74.0%; accuracy = 71.3%). Decision curve analysis indicated the clinical usefulness of radiomics score. CONCLUSIONS The portal rad-score is significantly associated with the pathologic SMV resection margin, and it can accurately and noninvasively predict the SMV resection margin in patients with pancreatic cancer.

中文翻译：

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基于CT的放射线学诊断胰腺头癌患者肠系膜上静脉切除边缘的性能。

目的准确鉴定门静脉放射学评分（rad-score）与病理性肠系膜上静脉（SMV）切除切缘之间的关系，并评估胰腺癌患者的诊断性能。材料与方法回顾性分析2016年1月至2018年12月在手术后1个月内接受多层螺旋CT术的181例经手术和病理证实的胰头癌患者。对于每位患者，提取了1029门期的放射学特征，并使用最小绝对收缩和选择算子（LASSO）逻辑回归算法将其减少。多变量logistic回归模型用于分析门静脉弧度评分与SMV切除切缘之间的关系。结果边缘阴性（R0）和阳性（R1）的患者分别占队列的70.17％（127）和29.83％（54）。rad评分与SMV切除切缘状态显着相关（p <0.05）。多变量分析证实门脉rad评分与SMV切除切缘之间存在显着且独立的关联（OR 4.62； 95％CI 2.19-9.76； p <0.0001）。门脉rad评分具有较高的准确性（曲线下面积= 0.750）。基于最大化敏感性和特异性总和的最佳切点为-0.741（敏感性= 64.8％；特异性= 74.0％；准确性= 71.3％）。决策曲线分析表明放射性组评分的临床实用性。结论门脉评分与病理性SMV切除切缘明显相关，