Purpose

To develop and validate a novel method based on radiomics for the preoperative differentiation of benign and malignant gallbladder polypoid lesions (PLG).

Patients and methods

A total of 145 patients with pathological proven gallbladder polypoid lesions ≥ 1 cm were included in this retrospective study. All the patients underwent abdominal contrast-enhanced computed tomography (CT) examinations 3 weeks before cholecystectomy from January 2013 to January 2019. Seventy percent of the cases were randomly selected for the training dataset, and 30% of the cases were independently used for testing. Radiomics features extracted from portal venous-phase CT of the PLG and clinical features were analyzed, and the LASSO regression algorithm was used for data dimension reduction. Multivariable logistic regression was used to generate radiomics signatures, clinical signatures, and combination signatures. The receiver operating characteristic (ROC) curve and decision curve were plotted to assess the differentiating performance of the three signatures.

Results

The area under the ROC curve (AUC) of the radiomics signature and clinical signature was 0.924 and 0.861 in the testing dataset, respectively. For the radiomics signature, the accuracy was 88.6%, with 88.0% specificity and 89.5% sensitivity. When combined, the AUC was 0.931, the specificity was 84.0%, and the sensitivity was 89.5%. The differences between the AUC values of the two sole models and the combination model were statistically nonsignificant.

Conclusion

Radiomics based on CT images can be helpful to differentiate benign and malignant gallbladder polyps ≥ 1 cm in size.

中文翻译：

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基于造影剂增强型CT和临床数据的放射线学在区分良性和恶性胆囊息肉样病变方面的实用性。

目的

要开发和验证一种基于放射组学的术前鉴别良性和恶性胆囊息肉样病变（PLG）的新方法。

患者和方法

这项回顾性研究共纳入145例经病理证实的胆囊息肉样病变≥1 cm的患者。从2013年1月至2019年1月，在胆囊切除术前3周，所有患者均接受了腹部对比增强计算机断层扫描（CT）检查。随机选择了70％的病例作为训练数据集，其中30％的病例被独立用于测试。分析了从门脉期CT的PLG提取的放射学特征和临床特征，并使用LASSO回归算法进行数据降维。多变量逻辑回归用于生成放射学特征，临床特征和组合特征。

结果

在测试数据集中，放射性组签名和临床签名的ROC曲线下面积（AUC）分别为0.924和0.861。对于放射性标记物，准确性为88.6％，特异性为88.0％，灵敏度为89.5％。组合时，AUC为0.931，特异性为84.0％，灵敏度为89.5％。两个单独模型和组合模型的AUC值之间的差异在统计学上不显着。

结论

基于CT图像的放射线检查有助于区分大小≥1 cm的良性和恶性胆囊息肉。