Radiomics based on HRCT can predict RP-ILD and mortality in anti-MDA5+dermatomyositis patients: a multi-center retrospective study

作者全名：He, Wenzhang; Cui, Beibei; Chu, Zhigang; Chen, Xiaoyi; Liu, Jing; Pang, Xueting; Huang, Xuan; Yin, Hongkun; Lin, Hui; Peng, Liqing

作者地址：[He, Wenzhang; Chen, Xiaoyi; Liu, Jing; Pang, Xueting; Peng, Liqing] Sichuan Univ, West China Hosp, Dept Radiol, 37 Guoxue Alley, Chengdu 610000, Peoples R China; [He, Wenzhang] Chongqing Univ, Chongqing Gen Hosp, Dept Radiol, Chongqing, Peoples R China; [Cui, Beibei; Lin, Hui] Sichuan Univ, West China Hosp, Dept Rheumatol & Immunol, 37 Guoxue Alley, Chengdu 610000, Sichuan, Peoples R China; [Chu, Zhigang] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China; [Huang, Xuan] Sichuan Univ, West China Hosp, Biomed Big Data Ctr, West China Sch Med, Chengdu, Peoples R China; [Yin, Hongkun] Inst Adv Res, Infervis Med Technol, Beijing, Peoples R China

通信作者：Peng, LQ (通讯作者)，Sichuan Univ, West China Hosp, Dept Radiol, 37 Guoxue Alley, Chengdu 610000, Peoples R China.; Lin, H (通讯作者)，Sichuan Univ, West China Hosp, Dept Rheumatol & Immunol, 37 Guoxue Alley, Chengdu 610000, Sichuan, Peoples R China.

来源：RESPIRATORY RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001252027600003

JCR分区：Q1

影响因子：4.7

年份：2024

卷号：25

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Radiomics; Dermatomyositis; Computed tomography; Interstitial lung disease; Survival analysis

摘要：Objectives To assess the effectiveness of HRCT-based radiomics in predicting rapidly progressive interstitial lung disease (RP-ILD) and mortality in anti-MDA5 positive dermatomyositis-related interstitial lung disease (anti-MDA5 + DM-ILD).Methods From August 2014 to March 2022, 160 patients from Institution 1 were retrospectively and consecutively enrolled and were randomly divided into the training dataset (n = 119) and internal validation dataset (n = 41), while 29 patients from Institution 2 were retrospectively and consecutively enrolled as external validation dataset. We generated four Risk-scores based on radiomics features extracted from four areas of HRCT. A nomogram was established by integrating the selected clinico-radiologic variables and the Risk-score of the most discriminative radiomics model. The RP-ILD prediction performance of the models was evaluated by using the area under the receiver operating characteristic curves, calibration curves, and decision curves. Survival analysis was conducted with Kaplan-Meier curves, Mantel-Haenszel test, and Cox regression.Results Over a median follow-up time of 31.6 months (interquartile range: 12.9-49.1 months), 24 patients lost to follow-up and 46 patients lost their lives (27.9%, 46/165). The Risk-score based on bilateral lungs performed best, attaining AUCs of 0.869 and 0.905 in the internal and external validation datasets. The nomogram outperformed clinico-radiologic model and Risk-score with AUCs of 0.882 and 0.916 in the internal and external validation datasets. Patients were classified into low- and high-risk groups with 50:50 based on nomogram. High-risk group patients demonstrated a significantly higher risk of mortality than low-risk group patients in institution 1 (HR = 4.117) and institution 2 cohorts (HR = 7.515).Conclusion For anti-MDA5 + DM-ILD, the nomogram, mainly based on radiomics, can predict RP-ILD and is an independent predictor of mortality.

基金机构：Key Research & Development Project of Science and Technology of Sichuan Province

基金资助正文：We are grateful to the patients for their contributions to this study.