The Value Of Radiomics In The Differential Diagnosis Of Benign And Malignant Intraductal Papillary Mucinous Neoplasms Of The Pancreas

Objective: To explore the value of radiomics analysis based on contrast enhanced CT images in differential diagnosis of benign and malignant intraductal papillary mucinous neoplasms(IPMNs)of the pancreas.Materials and Methods: A total of 103 patients pathologically confirmed branch duct IPMNs or mixed type IPMNs who underwent contrast enhanced CT within 1month before the operation were collected retrospectively from January 2010 to December 2019.The patients were divided into benign group of 67 cases and malignant group of 36 cases.All the patients underwent enhanced CT scan of upper abdomen within 1 month before surgery.The lesions were evaluated by conventional imaging,and multivariable Logistic regression analysis was performed on clinical and conventional imaging features that showed significant differences between two groups to determine independent predictors.Frontier post-processing software was used to extract radiomics features.Redundant features with correlation coefficients greater than 0.9 were removed and least absolute shrinkage and selection operator algorithm was performed to select radiomics features.The selected clinical and conventional imaging features and radiomics features were used to establish Logistic regression prediction models.Ten-fold cross validation method was used to evaluate the generalization ability of the prediction models with the ROC curves.Results: Elevated level of CA 19-9,mural nodule ? 5mm,truncation of pancreatic duct with distal pancreatic atrophy,and lymphadenopathy were independent predictors of the malignant IPMNs.Eight features with coefficients greater than 0.1were selected from the 1691 radiomics features.The prediction model established by clinical and conventional imaging features showed an AUC of 0.777(0.664,0.890),the prediction model established by radiomics features showed an AUC of 0.895(0.833,0.957),and the combined prediction model showed an AUC of 0.881(0.813,0.948).Conclusion: Radiomics analysis based on enhanced CT images showed good performance for differentiating between benign and malignant IPMNs.Objective: To compare the performance of CT and MRI radiomics for differentiating between benign and malignant intraductal papillary mucinous neoplasms(IPMNs)of the pancreas,and to investigate their value compared to the revised 2017 international consensus Fukuoka guidelines.Materials and Methods: Sixty patients with surgically confirmed IPMN(37 malignant and 23 benign)were included.Radiomics features were extracted from arterial and venous phase images of CT and T2-weighted images of MRI,respectively.Intraclass correlation coefficients for the radiomics features were calculated to assess the interobserver reproducibility.The least absolute shrinkage and selection operator algorithm was used for feature selection.Radiomics models were constructed based on selected features with logistic regression(LR)and support vector machine(SVM).A clinical and imaging model was constructed based on independent predictors of the revised 2017 Fukuoka guidelines determined in multivariate logistic regression with forward elimination.Results: The reproducibility of MRI radiomics features was higher than that of CT radiomics features,regardless of arterial or venous phase features(all P < 0.001).MRI radiomics models achieved improved AUCs(0.879 with LR and 0.940 with SVM,respectively),than that of CT radiomics models(0.811 with LR and 0.864 with SVM,respectively).All radiomics models provided better predictive performance than the clinical and imaging model(AUC = 0.764).Conclusion: The MRI radiomics models with higher reproducibility radiomics features performed better than CT radiomics models for predicting malignant IPMNs.The performance of radiomics models was superior to the clinical and imaging model based on Fukuoka guidelines.