The Study Of Discriminating Mediastinal Metastatic Lymph Nodes And Identifying Pathological Subtypes Of Non-small Cell Lung Cancer Assisted By Radiomics

Lung cancer is one of the most common malignant tumors in the world,and its morbidity and mortality rank first among malignant tumors,of which non-small cell lung cancer accounts for 80%.Mediastinal lymph node metastasis is the most common mode of metastasis in NSCLC.LN status is an important prognostic factor related to survival and recurrence and a key factor in determining the strategy of treatment.NSCLC can be further categorized into three main histological subtypes: adenocarcinoma,squamous cell carcinoma and large cell carcinoma,of which ADC and SqCC account for more than 70%.With the development of molecular biology and genomics,tumor typing becomes particularly important in the choice of treatment.Imaging examination plays an important role in the diagnosis,treatment and efficacy evaluation of NSCLC.Currently,the clinical application of medical images is limited to qualitative or semi-quantitative analysis of tumors.Radiomics can extract hundreds of features from medical images,and through in-depth analysis of these features,we can find useful information that can not be observed by the naked eye,so as to improve the accuracy of image examination and clinical application value.In present study,we screened the radiomic features that could distinguish NSCLC mediastinal metastatic lymph nodes,NSCLC subtypes and established predictive models.The results show that CT imaging models in all phases can be used to assist clinical diagnosis of lymph nodes.The model in the plain scan phase has the highest AUC value,while the combination of arterial phase CT images can improve the sensitivity and negative predictive value.18F-FDG PET imaging classification model is a promising and applicable method for identifying NSCLC subtypes,and can be used as an auxiliary tool to help doctors make clinical decisions.The main contents of this paper are as follows:1.Summarized the current situation and treatment strategy of NSCLC,mediastinal lymph node metastasis of NSCLC and the clinical manifestations of NSCLC subtypes,and leads to the purpose of the study.2.Introduced the emergence,development,workflow,application and challenges of radiomic in NSCLC.3.We introduced the diagnostic dilemma of NSCLC mediastinal lymph node metastasis,established radiomic models of different CT scanning phases to differentiate NSCLC mediastinal lymph nodes,and discussed the diagnostic efficiency of different models.4.We established three models for distinguishing NSCLC subtypes to explore the feasibility of PET radiomic in identifing tumor subtypes.5.Summarize the research results,and put forward the follow-up research direction.