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A radiomics-based formula for the preoperative prediction of postoperative pancreatic fistula in patients with pancreaticoduodenectomy

Authors Zhang WY, Cai W, He B, Xiang N, Fang C, Jia F

Received 30 August 2018

Accepted for publication 7 November 2018

Published 28 November 2018 Volume 2018:10 Pages 6469—6478

DOI https://doi.org/10.2147/CMAR.S185865

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Rituraj Purohit


Wenyu Zhang,1,2 Wei Cai,1,2 Baochun He,2,3 Nan Xiang,1 Chihua Fang,1 Fucang Jia2,3

1Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, People’s Republic of China; 2Research Lab for Medical Imaging and Digital Surgery, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, People’s Republic of China; 3Shenzhen Key Laboratory of Minimally Invasive Surgical Robotics and System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, People’s Republic of China

Objective: The objective of the study was to develop and validate a radiomics-based formula for the preoperative prediction of postoperative pancreatic fistula (POPF) in patients undergoing pancreaticoduodenectomy (PD).
Materials and methods: A total of 117 consecutive patients who underwent PD were enrolled in this retrospective study. Radiomics features were extracted from portal venous phase computed tomography of the above patients. The least absolute shrinkage and selection operator logistic regression was used to construct a formula of Rad-score calculation. Then the performance of the formula was assessed with standard pancreatic Fistula Risk Score.
Results: The Rad-score could predict POPF with an area under the curve (AUC) of 0.8248 in the training cohort and of 0.7609 in the validation cohort. Patients who had experienced POPF generally had a statistically higher Rad-score than those who had not experienced POPF in both cohorts. The AUC of the Rad-score was statistically higher than the Fistula Risk Score for predicting POPF in both the training and validation cohort.
Conclusion: A novel radiomics-based formula was developed and validated for predicting POPF in patients who underwent PD, which provides a new method for identifying POPF risks and may help to improve informed decision-making in the prevention of POPF at low cost.

Keywords: pancreatoduodenectomy, postoperative pancreatic fistula, diagnostic imaging, radiomics
 

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