Using nomogram model based on preoperative contrast-enhanced CT to predict R0 resection of pancreatic ductal adenocarcinoma(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2022年第8期
- Page:
- 957-962
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Using nomogram model based on preoperative contrast-enhanced CT to predict R0 resection of pancreatic ductal adenocarcinoma
- Author(s):
- LI Zhengxiao1; 2; 3; 4; LI Shenglin1; 2; 3; 4; XUE Caiqiang1; 2; 3; 4; LIU Suwei1; 2; 3; 4; SUN Jiachen1; 2; 3; 4; REN Tiezhu1; 2; 3; 4; ZHOU Junlin1; 2; 3; 4
- 1. Department of Radiology, Lanzhou University Second Hospital, Lanzhou 730030, China 2. The Second Clinical Medical School, Lanzhou University, Lanzhou 730030, China 3. Key Laboratory of Medical Imaging of Gansu Province, Lanzhou 730030, China 4. Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou 730030, China
- Keywords:
- Keywords: pancreatic ductal adenocarcinoma R0 resection contrast-enhanced CT nomogram model
- PACS:
- R318；R445
- DOI:
- DOI:10.3969/j.issn.1005-202X.2022.08.007
- Abstract:
- Abstract: Objective To investigate the value of preoperative enhanced CT scan features combined with clinical features to construct a nomogram model for predicting whether the R0 resection of pancreatic ductal adenocarcinoma (PDAC) can be achieved. Methods The preoperative contrast-enhanced CT imaging data of 106 patients with PDAC who were confirmed by surgery and pathology and whose resection margin status was evaluated were retrospectively analyzed. According to the resection margin status, they were divided into R0 resection group and R1 resection group. The preoperative CA199, CA125, CEA and other clinical data of the patients were analyzed. Before surgery, the tumor location, the transverse diameter of the tumor, the maximum angle between the tumor and the surrounding blood vessels (T/artery angle, T/portal vein angle, T/superior mesenteric vein angle), peritumoral fat space and lymph node metastasis were also observed in preoperative contrast-enhanced CT. Then, univariate and multivariate Logistic regressions were used to construct a nomogram model for the preoperative prediction of whether the R0 resection of PDAC can be achieved. Results There were significant differences between R0 resection group and R1 resection group in the transverse diameter of the tumor, CA199, CA125, CEA, T/artery angle, T/portal vein angle, T/superior mesenteric vein, and lymph node metastasis (P<0.05). Univariate and multivariate Logistic regression analyses showed that lymph node metastasis ［OR: 0.205 (95%CI: 0.043-0.972), P<0.05］, T/artery angle ［OR: 0.085 (95%CI: 0.017-0.434), P<0.01］, T/portal vein angle ［OR: 0.155 (95%CI: 0.031-0.783), P<0.05］, the transverse diameter of the tumor ［OR: 1.073 (95%CI: 1.004-1.146), P<0.05］, CA199 ［OR: 1.003 (95%CI: 1.001-1.005), P<0.01］ were independent risk factors for R0 resection. The model constructed by multivariate Logistic regression could effectively predict the R0 resection of PDAC. The calibration curve revealed that the predicted probability of the nomogram model could better fit the actual probability, with high calibration. Conclusion Preoperative lower level of CA199, shorter transverse diameter of the tumor, T/artery angle and T/portal vein angle <180°, and non-lymph node metastasis were independent predictors of the R0 resection of PDAC, and the nomogram model can effectively predict whether the R0 resection of PDAC can be achieved.
Last Update: 2022-09-05