Abstract
Objectives
To predict the recurrence of acute pancreatitis (AP) by constructing a radiomics model of contrast-enhanced computed tomography (CECT) at AP first attack.
Methods
We retrospectively enrolled 389 first-attack AP patients (271 in the primary cohort and 118 in the validation cohort) from three tertiary referral centers; 126 and 55 patients endured recurrent attacks in each cohort. Four hundred twelve radiomics features were extracted from arterial and venous phase CECT images, and clinical characteristics were gathered to develop a clinical model. An optimal radiomics signature was chosen using a multivariable logistic regression or support vector machine. The radiomics model was developed and validated by incorporating the optimal radiomics signature and clinical characteristics. The performance of the radiomics model was assessed based on its calibration and classification metrics.
Results
The optimal radiomics signature was developed based on a multivariable logistic regression with 10 radiomics features. The classification accuracy of the radiomics model well predicted the recurrence of AP for both the primary and validation cohorts (87.1% and 89.0%, respectively). The area under the receiver operating characteristic curve (AUC) of the radiomics model was significantly better than that of the clinical model for both the primary (0.941 vs. 0.712, p = 0.000) and validation (0.929 vs. 0.671, p = 0.000) cohorts. Good calibration was observed for all the models (p > 0.05).
Conclusions
The radiomics model based on CECT performed well in predicting AP recurrence. As a quantitative method, radiomics exhibits promising performance in terms of alerting recurrent patients to potential precautions.
Key Points
• The incidence of recurrence after an initial episode of acute pancreatitis is high, and quantitative methods for predicting recurrence are lacking.
• The radiomics model based on contrast-enhanced computed tomography performed well in predicting the recurrence of acute pancreatitis.
• As a quantitative method, radiomics exhibits promising performance in terms of alerting recurrent patients to the potential need to take precautions.
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Abbreviations
- AP:
-
Acute pancreatitis
- AUC:
-
Area under the receiver operating characteristic curve
- CECT:
-
Contrast-enhanced computed tomography
- CTSI:
-
Computed tomography severity index
- GLCM:
-
Gray-level co-occurrence matrix
- GLRLM:
-
Gray-level run length matrix
- ICC:
-
Intraclass correlation coefficient
- LASSO:
-
Least absolute shrinkage and selection operator
- NPV:
-
Negative predictive value
- PACS:
-
Picture archiving and communication system
- PPV:
-
Positive predictive value
- RAC:
-
Revised Atlanta Criteria
- RAP:
-
Recurrent acute pancreatitis
- ROC:
-
Receiver operating characteristic curve
- ROI:
-
Region of interest
- SVM:
-
Support vector machine
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Acknowledgements
Thanks are due to Dr. Xin Li for the assistance with statistics and data visualization.
Funding
This work was supported by the National Natural Science Foundation of China (Grant No. 81871440) and the Training Program for Science and Technology Innovation of Sichuan Province (Grant No. 2018036).
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The scientific guarantor of this publication is Xiao Ming Zhang, MD.
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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
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Dr. Xin Li kindly provided statistical advice for this manuscript.
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Written informed consent was waived by the Institutional Review Board.
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Methodology
• retrospective
• diagnostic or prognostic study
• multicenter study
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Chen, Y., Chen, Tw., Wu, Cq. et al. Radiomics model of contrast-enhanced computed tomography for predicting the recurrence of acute pancreatitis. Eur Radiol 29, 4408–4417 (2019). https://doi.org/10.1007/s00330-018-5824-1
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DOI: https://doi.org/10.1007/s00330-018-5824-1