Improved lymph node metastasis prediction from preoperative esophageal squamous cell cancer CT by graph attention convolutional neural network (GACNN).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16093-e16093
Author(s):  
Mingjun Ding ◽  
Hui Cui ◽  
Butuo Li ◽  
Bing Zou ◽  
Yiyue Xu ◽  
...  

e16093 Background: Lymph node (LN) metastasis is the most important factor for decision making in esophageal squamous cell carcinoma (ESCC). A more accurate prediction model for LN metastatic status in ESCC patients is needed. Methods: In this retrospective study, 397 ESCC patients who took Contrast-Enhanced CT (CECT) within 15 days before surgery between October 2013 and November 2018 were collected. There are 924 (798 negative and 126 positive) LNs with pathologically confirmed status after surgery. All LNs were randomly divided into a training set (n = 663) and validation set (n = 185). Data augmentation including shifting and rotation was performed in the training set, resulting in 1326 negative and 1140 positive LN samples. The GACNN model was trained over CT volumetric patches centred at manually segmented LN samples. GACNN was composed of a 3D UNet encoder to extract deep features, and a graph attention layer to integrate morphological features extracted from segmented LN. The model was validated using the validation set (135 negative and 50 positive) and measured by area under ROC curve (auc), sensitivity (sen), and specificity (spe). Results: GACNN achieved better auc, sen, and spe of 0.802, 0.765, and 0.826, when compared to 3 other models including CT radiomics model (auc 0.733, sen 0.689, spe 0.765), 3D UNet encoder (auc 0.778, sen 0.722, spe 0.767), and our model without morphological features (auc 0.796, sen 0.754, spe 0.803). The improvement was statistically significant (p < 0.001). Conclusions: Our prediction model improved the prediction of LN metastasis, which has the potential to assist LN metastasis risk evaluation and personalized treatment planning in ESCC patients for surgery or radiotherapy.

2020 ◽  
Author(s):  
Hesan Luo ◽  
Shao-Fu Huang ◽  
Hong-Yao Xu ◽  
Xu-Yuan Li ◽  
Sheng-Xi Wu ◽  
...  

Abstract Purpose: To develop and validate a nomogram model to predict complete response (CR) after concurrent chemoradiotherapy (CCRT) in esophageal squamous cell carcinoma (ESCC) patients using pretreatment CT radiomic features. Methods: Data of patients diagnosed as ESCC and treated with CCRT in Shantou Central Hospital during the period from January 2013 to December 2015 were retrospectively collected. Eligible patients were included in this study and randomize divided into a training set and a validation set after successive screening. The least absolute shrinkage and selection operator (LASSO) with logistic regression to select radiomics features calculating Rad-score in the training set. The logistic regression analysis was performed to identify the predictive clinical factors for developing a nomogram model. The area under the receiver operating characteristic curves (AUC) was used to assess the performance of the predictive nomogram model and decision curve was used to analyze the impact of the nomogram model on clinical treatment decisions. Results: A total of 226 patients were included and randomly divided into two groups, 160 patients in training set and 66 patients in validation set. After LASSO analysis, seven radiomics features were screened out to develop a radiomics signature Rad-score. The AUC of Rad-score was 0.812 (95%CI: 0.742-0.869, p<0.001) in the training set and 0.744 (95%CI: 0.632-0.851, p=0.003) in the validation set. Multivariate analysis showed that Rad-score and clinical staging were independent predictors of CR status, with P values of 0.035 and 0.023, respectively. A nomogram model incorporating Rad-socre and clinical staging was developed and validated, with an AUC of 0.844 (95%CI: 0.779-0.897) in the training set and 0.807 (95%CI: 0.691-0.894) in the validation set.Delong test showed that the nomogram model was significantly superior to the clinical staging, with P<0.001 in the training set and P=0.026 in the validation set. The decision curve showed that the nomogram model was superior to the clinical staging when the risk threshold was greater than 25%. Conclusion: We developed and validated a nomogram model for predicting CR status of ESCC patients after CCRT. The nomogram model was combined radiomics signature Rad-score and clinical staging. This model provided us with an economical and simple method for evaluating the response of chemoradiotherapy for patients with ESCC.


2020 ◽  
Author(s):  
Hesan Luo ◽  
Shao-Fu Huang ◽  
Hong-Yao Xu ◽  
Xu-Yuan Li ◽  
Sheng-Xi Wu ◽  
...  

Abstract Purpose To develop and validate a nomogram model to predict complete response (CR) after concurrent chemoradiotherapy (CCRT) in esophageal squamous cell carcinoma (ESCC) patients using pretreatment CT radiomic features. Methods Data of patients diagnosed as ESCC and treated with CCRT in Shantou Central Hospital during the period from January 2013 to December 2015 were retrospectively collected. Eligible patients were included in this study and randomize divided into a training set and a validation set after successive screening. The least absolute shrinkage and selection operator (LASSO) with logistic regression to select radiomics features calculating Rad-score in the training set. The logistic regression analysis was performed to identify the predictive clinical factors for developing a nomogram model. The area under the receiver operating characteristic curves (AUC) was used to assess the performance of the predictive nomogram model and decision curve was used to analyze the impact of the nomogram model on clinical treatment decisions. Results A total of 226 patients were included and randomly divided into two groups, 160 patients in training set and 66 patients in validation set. After LASSO analysis, seven radiomics features were screened out to develop a radiomics signature Rad-score. The AUCs of Rad-score was 0.812 (95%CI: 0.742–0.869) in the training set and 0.744 (95%CI: 0.632–0.851) in the validation set. Multivariate analysis showed that Rad-score and clinical staging were independent predictors of CR status, with P values of 0.035 and 0.023, respectively. A nomogram model incorporating Rad-socre and clinical staging was developed and validated, with an AUC of 0.844 (95%CI: 0.779–0.897) in the training set and 0.807 (95༅CI: 0.691–0.894) in the validation set༎Delong test showed that the nomogram model was significantly superior to the clinical staging, with P < 0.001 in the training set and P = 0.026 in the validation set. The decision curve showed that the nomogram model was superior to the clinical staging when the risk threshold was greater than 25%. Conclusion We developed and validated a nomogram model for predicting CR status of ESCC patients after CCRT. The nomogram model was combined radiomics signature Rad-score and clinical staging. This model provided us with an economical and simple method for evaluating the response of chemoradiotherapy for patients with ESCC.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
He-San Luo ◽  
Shao-Fu Huang ◽  
Hong-Yao Xu ◽  
Xu-Yuan Li ◽  
Sheng-Xi Wu ◽  
...  

Abstract Purpose To develop and validate a nomogram model to predict complete response (CR) after concurrent chemoradiotherapy (CCRT) in esophageal squamous cell carcinoma (ESCC) patients using pretreatment CT radiomic features. Methods Data of patients diagnosed as ESCC and treated with CCRT in Shantou Central Hospital during the period from January 2013 to December 2015 were retrospectively collected. Eligible patients were included in this study and randomize divided into a training set and a validation set after successive screening. The least absolute shrinkage and selection operator (LASSO) with logistic regression to select radiomics features calculating Rad-score in the training set. The logistic regression analysis was performed to identify the predictive clinical factors for developing a nomogram model. The area under the receiver operating characteristic curves (AUC) was used to assess the performance of the predictive nomogram model and decision curve was used to analyze the impact of the nomogram model on clinical treatment decisions. Results A total of 226 patients were included and randomly divided into two groups, 160 patients in training set and 66 patients in validation set. After LASSO analysis, seven radiomics features were screened out to develop a radiomics signature Rad-score. The AUC of Rad-score was 0.812 (95% CI 0.742–0.869, p < 0.001) in the training set and 0.744 (95% CI 0.632–0.851, p = 0.003) in the validation set. Multivariate analysis showed that Rad-score and clinical staging were independent predictors of CR status, with p values of 0.035 and 0.023, respectively. A nomogram model incorporating Rad-socre and clinical staging was developed and validated, with an AUC of 0.844 (95% CI 0.779–0.897) in the training set and 0.807 (95% CI 0.691–0.894) in the validation set. Delong test showed that the nomogram model was significantly superior to the clinical staging, with p < 0.001 in the training set and p = 0.026 in the validation set. The decision curve showed that the nomogram model was superior to the clinical staging when the risk threshold was greater than 25%. Conclusion We developed and validated a nomogram model for predicting CR status of ESCC patients after CCRT. The nomogram model was combined radiomics signature Rad-score and clinical staging. This model provided us with an economical and simple method for evaluating the response of chemoradiotherapy for patients with ESCC.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li Liu ◽  
Zhiyong Chen ◽  
Yingrong Du ◽  
Jianpeng Gao ◽  
Junyi Li ◽  
...  

AbstractTo evaluate the predictive effect of T-lymphoid subsets on the conversion of common covid-19 to severe. The laboratory data were collected retrospectively from common covid-19 patients in the First People's Hospital of Zaoyang, Hubei Province, China and the Third People's Hospital of Kunming, Yunnan Province, China, between January 20, 2020 and March 15, 2020 and divided into training set and validation set. Univariate and multivariate logistic regression was performed to investigate the risk factors for the conversion of common covid-19 to severe in the training set, the prediction model was established and verified externally in the validation set. 60 (14.71%) of 408 patients with common covid-19 became severe in 6–10 days after diagnosis. Univariate and multiple logistic regression analysis revealed that lactate (P = 0.042, OR = 1097.983, 95% CI 1.303, 924,798.262) and CD8+ T cells (P = 0.010, OR = 0.903, 95% CI 0.835, 0.975) were independent risk factors for general type patients to turn to severe type. The area under ROC curve of lactate and CD8+ T cells was 0.754 (0.581, 0.928) and 0.842 (0.713, 0.970), respectively. The actual observation value was highly consistent with the prediction model value in curve fitting. The established prediction model was verified in 78 COVID-19 patients in the verification set, the area under the ROC curve was 0.906 (0.861, 0.981), and the calibration curve was consistent. CD8+ T cells, as an independent risk factor, could predict the transition from common covid-19 to severe.


Author(s):  
Yu Mei ◽  
Shuo Wang ◽  
Tienan Feng ◽  
Min Yan ◽  
Fei Yuan ◽  
...  

Objective: We aimed to establish a nomogram for predicting lymph node metastasis in early gastric cancer (EGC) involving human epidermal growth factor receptor 2 (HER2).Methods: We collected clinicopathological data of patients with EGC who underwent radical gastrectomy and D2 lymphadenectomy at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between January 2012 and August 2018. Univariate and multivariate logistic regression analysis were used to examine the relationship between lymph node metastasis and clinicopathological features. A nomogram was constructed based on a multivariate prediction model. Internal validation from the training set was performed using receiver operating characteristic (ROC) and calibration plots to evaluate discrimination and calibration, respectively. External validation from the validation set was utilized to examine the external validity of the prediction model using the ROC plot. A decision curve analysis was used to evaluate the benefit of the treatment.Results: Among 1,212 patients with EGC, 210 (17.32%) presented with lymph node metastasis. Multivariable analysis showed that age, tumor size, submucosal invasion, histological subtype, and HER2 positivity were independent risk factors for lymph node metastasis in EGC. The area under the ROC curve of the model was 0.760 (95% CI: 0.719–0.800) in the training set (n = 794) and 0.771 (95% CI: 0.714–0.828) in the validation set (n = 418). A predictive nomogram was constructed based on a multivariable prediction model. The decision curve showed that using the prediction model to guide treatment had a higher net benefit than using endoscopic submucosal dissection (ESD) absolute criteria over a range of threshold probabilities.Conclusion: A clinical prediction model and an effective nomogram with an integrated HER2 status were used to predict EGC lymph node metastasis with better accuracy and clinical performance.


We report a very rare case of squamous cell cancer of the right foot which had metastasize to the ipsilateral popliteal lymph node after initial diagnosis and treatment for the loco-regional disease.


Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Kohkichi Hosoda ◽  
Nobuyuki Akutsu ◽  
Atsushi Fujita ◽  
Eiji Kohmura

[Objective] Recently, we reported a preliminary prediction model with carotid plaque MRI to estimate risk for new ischaemic brain lesions after CEA or CAS. The objective of this study was to validate this model in new set of patients with carotid stenosis. [Methods] One hundred four patients with carotid stenosis undergoing treatment (63 CEA, 41 CAS) were used as a training set for construction of a preliminary prediction model to estimate risk for new ischemic brain lesions after CEA or CAS. T1 and T2 signal intensity of carotid plaque were measured on black-blood MRI. Associations among MRI findings, treatment, clinical factors, and occurrence of new ischemic lesions on DWI 1 day after treatment were studied by logistic regression. The validity of the prediction model was examined using a new set of patients with carotid stenosis (n = 43) as a validation set. [Results] In the training set, new DWI lesions after treatment were observed in 25 patients (24%). The model demonstrated that T1-signal intensity and CAS were positively associated with new lesions on post-treatment DWI scans, and T2 signal intensity was negatively associated (Fig. 1). The C-index was 0.79, which indicated some predictive value. In the validation set, new DWI lesions after treatment were observed in 10 patients (23%). However, C-index was 0.6 and positive predictive value was 33% (Fig. 2), which suggested overfitting of our model and/or differences in case-mix between the training set and validation set. [Conclusions] Our preliminary prediction model may provide some useful information for decision-making regarding treatment strategy, but needs further collection of patients to improve its predictive value.


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