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Pancreatic Ductal Adenocarcinoma: Machine Learning–Based Quantitative Computed Tomography Texture Analysis For Prediction Of Histopathological Grade

Authors Qiu W, Duan N, Chen X, Ren S, Zhang Y, Wang Z, Chen R

Received 7 June 2019

Accepted for publication 15 October 2019

Published 30 October 2019 Volume 2019:11 Pages 9253—9264

DOI https://doi.org/10.2147/CMAR.S218414

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


Wenli Qiu,1 Na Duan,1 Xiao Chen,1 Shuai Ren,1 Yifen Zhang,2 Zhongqiu Wang,1 Rong Chen3

1Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 2Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 3Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Correspondence: Zhongqiu Wang
Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing 210029, Jiangsu Province, People’s Republic of China
Tel +86 25 8661 8472
Fax +86 25 8661 8139
Email zhq200105@sina.com

Purpose: To assess the performance of combining computed tomography (CT) texture analysis with machine learning for discriminating different histopathological grades of pancreatic ductal adenocarcinoma (PDAC).
Methods: From July 2012 to August 2017, this retrospective study comprised 56 patients with confirmed histopathological PDAC (32 men, 24 women, mean age 64.04±7.82 years) who had undergone preoperative contrast-enhanced CT imaging within 1 month before surgery. Two radiologists blinded to the histopathological outcome independently segmented lesions for quantitative texture analysis. Histogram features, co-occurrence, and run-length texture were calculated. A support-vector machine was constructed to predict the pathological grade of PDAC based on preoperative texture features.
Results: Pathological analysis confirmed 37 low-grade PDAC (five well-differentiated/grade I and 32 moderately differentiated/grade II) and 19 high-grade PDAC (19 poorly differentiated/grade III) tumors. There were no significant differences in clinical or biological characteristics between patients with high-grade and low-grade tumors (P>0.05). There were significant differences between low-grade PDAC and high-grade PDAC on nine histogram features, seven run-length features, and two co-occurrence features. Cluster shade was the most important predictor (sensitivity 0.315). Using these texture features, the support-vector machine achieved 86% accuracy, 78% sensitivity, 95% and specificity.
Conclusion: Machine learning–based CT texture analysis accurately predicted histopathological differentiation grade of PDAC based on preoperative texture features, leading to maximization patient survival and achievement of personalized precision treatment.

Keywords: computed tomography, texture analysis, machine learning, pancreatic ductal adenocarcinoma, histopathological grade


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