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Pretreatment Prediction of Immunoscore in Hepatocellular Cancer: A Radiomics Nomogram Based on Gadolinium-Ethoxybenzyl-Diethylenetriamine Enhanced Magnetic Resonance Imaging

51 Pages Posted: 13 Sep 2018

See all articles by Shuling Chen

Shuling Chen

Sun Yat-Sen University (SYSU) - Department of Medical Ultrasonics

Shiting Feng

Sun Yat-Sen University (SYSU) - Department of Radiology

Jingwei Wei

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences

Fei Liu

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences

Bin Li

Sun Yat-Sen University (SYSU), First Affiliated Hospital, Clinical Trial Unit

Xin Li

GE HealthCare China

Yang Hou

Jinan University - Department of Mathematics

Dongsheng Gu

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences

Mimi Tang

Sun Yat-Sen University (SYSU) - Department of Gastroenterology and Hepatology

Han Xiao

Sun Yat-Sen University (SYSU) - Department of Gastroenterology and Hepatology

Yingmei Jia

Sun Yat-Sen University (SYSU) - Department of Radiology

Sui Peng

Sun Yat-Sen University (SYSU), First Affiliated Hospital, Clinical Trial Unit; Sun Yat-Sen University (SYSU) - Department of Gastroenterology and Hepatology

Jie Tian

Guangdong Academy of Medical Sciences - CAS Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging; Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences; Xidian University - Engineering Research Center of Molecular and Neuro Imaging

Ming Kuang

Sun Yat-Sen University (SYSU) - Department of Medical Ultrasonics; Sun Yat-Sen University (SYSU) - Department of Liver Surgery

More...

Abstract

Background: Pretreatment prediction of Immunoscore in patients with hepatocellular cancer (HCC) is important for precision immunotherapy. We aimed to develop a radiomics nomogram based on Gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) for pretreatment prediction of Immunoscore (0-2 vs. 3-4) in HCC patients.  

Methods: The study included 207 (training cohort: n=150; validation cohort: n=57) HCC patients with hepatectomy who underwent preoperative Gd-EOB-DTPA enhanced MRI. The volumes of interest enclosing hepatic lesions including intratumoral and peritumoral regions were manually delineated in the hepatobiliary phase of MRI images, from which 1044 quantitative features were extracted and analyzed. Extremely Randomized Tree method was used to select radiomics features for building radiomics model. A radiomics nomogram was developed by incorporating selected radiomics features and clinical variables. Nomogram discrimination and calibration were assessed.  

Findings: The combined intratumoral and peritumoral radiomics model showed a better predicting performance in Immunoscore than intratumoral radiomics model (AUC, 0*904 (95% confidence interval [CI]: 0*855-0*953) vs. 0*823 (95% CI: 0*747-0*899), P=0*036). The radiomics nomogram showed an improvement over the combined radiomics model regarding predicting Immunoscore in the training cohort (AUC, 0*926 (95% CI: 0*884-0*967) vs. 0*904 (95% CI: 0*855-0*953)), although the differences were not statistically significant (P=0*128). Results were confirmed in the validation cohort and calibration curves showed good agreement.  

Interpretation: The radiomics nomogram incorporating clinical data and the combined radiomics features from Gd-EOB-DTPA enhanced MRI images is effective in predicting Immunoscore in HCC patients, and may assist clinicians to make pretreatment decisions for potential benefits of prognosis.  

Funding: This work is supported by grants from the Guangzhou Science and Technology Program key projects (No. 201803010057) and the National Natural Science Foundation of China (No. 81771908, 81571750).

Declaration of Interest: We declare that we have no conflicts of interest.

Ethical Approval: The Institutional Ethic Review Board has approved our study and the informed consent was waived.

Keywords: Immunoscore; Radiomics; MRI; Nomogram; Hepatocellular carcinoma

Suggested Citation

Chen, Shuling and Feng, Shiting and Wei, Jingwei and Liu, Fei and Li, Bin and Li, Xin and Hou, Yang and Gu, Dongsheng and Tang, Mimi and Xiao, Han and Jia, Yingmei and Peng, Sui and Tian, Jie and Kuang, Ming, Pretreatment Prediction of Immunoscore in Hepatocellular Cancer: A Radiomics Nomogram Based on Gadolinium-Ethoxybenzyl-Diethylenetriamine Enhanced Magnetic Resonance Imaging (July 30, 2018). Available at SSRN: https://ssrn.com/abstract=3223925 or http://dx.doi.org/10.2139/ssrn.3223925

Shuling Chen

Sun Yat-Sen University (SYSU) - Department of Medical Ultrasonics ( email )

China

Shiting Feng

Sun Yat-Sen University (SYSU) - Department of Radiology

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Jingwei Wei

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging

Beijing, 100190
China

Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences

Building 7, NO. 80 Zhongguancun Road
Beijing, Beijing 100190
China

Fei Liu

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging

Beijing, 100190
China

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging

Beijing, 100190
China

Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences

Building 7, NO. 80 Zhongguancun Road
Beijing, Beijing 100190
China

Bin Li

Sun Yat-Sen University (SYSU), First Affiliated Hospital, Clinical Trial Unit ( email )

China

Xin Li

GE HealthCare China

China

Yang Hou

Jinan University - Department of Mathematics

China

Dongsheng Gu

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging

Beijing, 100190
China

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging

Beijing, 100190
China

Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences

Building 7, NO. 80 Zhongguancun Road
Beijing, Beijing 100190
China

Mimi Tang

Sun Yat-Sen University (SYSU) - Department of Gastroenterology and Hepatology

135, Xingang Xi Road
Guangdong, Guangdong 510275
China

Han Xiao

Sun Yat-Sen University (SYSU) - Department of Gastroenterology and Hepatology ( email )

135, Xingang Xi Road
Guangdong, Guangdong 510275
China

Yingmei Jia

Sun Yat-Sen University (SYSU) - Department of Radiology

135, Xingang Xi Road
Guangzhou, Guangdong 510275
China

Sui Peng

Sun Yat-Sen University (SYSU), First Affiliated Hospital, Clinical Trial Unit ( email )

China

Sun Yat-Sen University (SYSU) - Department of Gastroenterology and Hepatology

135, Xingang Xi Road
Guangdong, Guangdong 510275
China

Jie Tian

Guangdong Academy of Medical Sciences - CAS Key Laboratory of Molecular Imaging ( email )

No. 95 Zhongguancun East Road
Beijing, 100190
China

Chinese Academy of Sciences (CAS) - Beijing Key Laboratory of Molecular Imaging ( email )

Beijing, 100190
China

Chinese Academy of Sciences (CAS) - University of Chinese Academy of Sciences ( email )

Building 7, NO. 80 Zhongguancun Road
Beijing, Beijing 100190
China

Xidian University - Engineering Research Center of Molecular and Neuro Imaging ( email )

Shaanxi, 710071
China

Ming Kuang (Contact Author)

Sun Yat-Sen University (SYSU) - Department of Medical Ultrasonics ( email )

China

Sun Yat-Sen University (SYSU) - Department of Liver Surgery ( email )

China

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