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Automatic prediction of hepatic arterial infusion chemotherapy response in advanced hepatocellular carcinoma with deep learning radiomic nomogram

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机构: [1]Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, No. 30 Shuangqing Road, Haidian District, Beijing 100084, China [2]Department of Minimal Invasive Intervention, Sun Yat-sen University Cancer Center, Guangzhou, China [3]Department of Minimal Invasive Intervention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China [4]Department of Ultrasound, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China [5]Department of Minimal Invasive Intervention, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China [6]Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Xicheng District, Beijing 100053, China
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Hepatic arterial infusion chemotherapy (HAIC) using the FOLFOX regimen (oxaliplatin plus fluorouracil and leucovorin) is a promising option for advanced hepatocellular carcinoma (Ad-HCC). As identifying patients with Ad-HCC who would obtain objective response (OR) to HAIC preoperatively remains a challenge, we aimed to develop an automatic and non-invasive model for predicting HAIC response.A total of 458 patients with Ad-HCC who underwent HAIC were retrospectively included from three hospitals (310 for training, 77 for internal validation, and 71 for external validation). The deep learning and radiomic features were extracted from the automatically segmented liver region on contrast-enhanced computed tomography images. Then, a deep learning radiomic nomogram (DLRN) was constructed by integrating deep learning scores, radiomic scores, and significant clinical variables with multivariate logistic regression. Model performance was assessed by AUC and Kaplan-Meier estimator.After automatic segmentation, only a few modifications were needed (less than 30 min for 458 patients). The DLRN achieved an AUC of 0.988 in the training cohort, 0.915 in the internal validation cohort, and 0.896 in the external validation cohort, respectively, outperforming other models in HAIC response prediction. Moreover, survival risk stratification was also successfully performed by the DLRN. The overall survival (OS) of the predictive OR group was significantly longer than that of the predictive non-OR group (median OS: 26.0 vs. 12.3 months, p < 0.001).The DLRN provided a satisfactory performance for predicting HAIC response, which is essential to identify Ad-HCC patients for HAIC and may potentially benefit personalized pre-treatment decision-making.This study presents an accurate and automatic method for predicting response to hepatic arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma, and therefore help in defining the best candidates for this treatment.• Deep learning radiomic nomogram (DLRN) based on automatic segmentation of CECT can accurately predict hepatic arterial infusion chemotherapy (HAIC) response of advanced HCC patients. • The proposed prediction model can perform survival risk stratification and is an easy-to-use tool for personalized pre-treatment decision-making for advanced HCC patients.© 2023. The Author(s), under exclusive licence to European Society of Radiology.

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出版当年[2022]版:
大类 | 2 区 医学
小类 | 2 区 核医学
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大类 | 2 区 医学
小类 | 2 区 核医学
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出版当年[2021]版:
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

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第一作者机构: [1]Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, No. 30 Shuangqing Road, Haidian District, Beijing 100084, China
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