Ternary-Classification Habitat Model for Invasiveness and Grade of Lung Adenocarcinoma Presenting as a Subsolid Nodule on Low-Dose Chest CT: A Multicenter Study
机构:[1]Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.四川省肿瘤医院[2]Department of Radiology, Deyang People's Hospital, Deyang, China.[3]Department of Radiology, People's Hospital of Lezhi, Ziyang, China.[4]Department of Radiology, Chengdu First People's Hospital, Chengdu, China.
BACKGROUND. Habitat imaging provides a novel approach to capture spatial heterogeneity within lesions. OBJECTIVE. To develop a ternary-classification habitat model to characterize lung adenocarcinoma presenting as a subsolid nodule (SSN) on CT and to test the model's diagnostic performance compared with 2D and radiomic models. METHODS. This retrospective study included 747 patients (median age, 56 years; 241 male, 506 female) with 834 resected lung adenocarcinomas that presented as SSNs on low-dose CT between July 2018 and May 2023. Adenocarcinomas from one center were divided into training (n=440) and internal test (n=189) sets; adenocarcinomas from three other centers formed an external test set (n=205). Adenocarcinomas were classified as noninvasive adenocarcinoma, grade 1 invasive adenocarcinoma (IAC), or grade 2 or 3 (hereafter, grade 2/3) IAC. Ternary-classification models were built in the training set using multivariable multinomial logistic regression analyses (2D model: diameter and consolidation-to-tumor ratio; habitat model: volume and volume ratio of attenuation-based subregions; radiomic model: extracted radiomic features; combined model: habitat and radiomic features). Performance was evaluated using macro-averaged and class-specific AUCs. RESULTS. The optimal number of habitats was four. The 2D, habitat, radiomic, and combined models had macro-averaged AUCs in the internal test set of 0.857, 0.909, 0.914, and 0.912, and in the external test of 0.871, 0.919, 0.924, and 0.926, respectively. Those four models had class-specific AUCs in the external test set for noninvasive adenocarcinoma of 0.945, 0.956, 0.961, and 0.955; grade 1 IAC of 0.792, 0.858, 0.857, and 0.862; and grade 2/3 IAC of 0.875, 0.940, 0.952, and 0.961, respectively. In the external test set, macro-averaged AUCs and class-specific AUCs for grades 1 and 2/3 IAC were significantly higher for habitat, radiomic, and combined models versus 2D model, but not for other model comparisons; class-specific AUCs for noninvasive adenocarcinoma were not significantly different for any model comparisons. CONCLUSION. The habitat model performed significantly better than the 2D model in ternary adenocarcinomas classification; its performance was not significantly different from radiomic and combined models. CLINICAL IMPACT. The habitat model's combination of interpretability and diagnostic performance support its utility for noninvasive risk stratification of SSNs encountered during lung cancer screening.
基金:
Supported by the National Natural Science Foundation of China (82202141), the Sichuan Provincial Natural
Science Foundation (2025ZNSFSC1765), and the Fundamental Research Funds for the Central Universities
(ZYGX2021YGCX017).
语种:
外文
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出版当年[2025]版:
大类|2 区医学
小类|2 区核医学
最新[2025]版:
大类|2 区医学
小类|2 区核医学
第一作者:
第一作者机构:[1]Department of Radiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
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推荐引用方式(GB/T 7714):
Li Yong,Long Yu,Zheng Yongji,et al.Ternary-Classification Habitat Model for Invasiveness and Grade of Lung Adenocarcinoma Presenting as a Subsolid Nodule on Low-Dose Chest CT: A Multicenter Study[J].AJR. American Journal Of Roentgenology.2025,doi:10.2214/AJR.25.33352.
APA:
Li Yong,Long Yu,Zheng Yongji,Liang Junqiang,Lin Wei...&Liu Jieke.(2025).Ternary-Classification Habitat Model for Invasiveness and Grade of Lung Adenocarcinoma Presenting as a Subsolid Nodule on Low-Dose Chest CT: A Multicenter Study.AJR. American Journal Of Roentgenology,,
MLA:
Li Yong,et al."Ternary-Classification Habitat Model for Invasiveness and Grade of Lung Adenocarcinoma Presenting as a Subsolid Nodule on Low-Dose Chest CT: A Multicenter Study".AJR. American Journal Of Roentgenology .(2025)