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arXiv 2603.10216cs.CV

一种用于结直肠肝转移术后生存预测的自动化放射组学框架,利用术前MRI

An Automated Radiomics Framework for Postoperative Survival Prediction in Colorectal Liver Metastases using Preoperative MRI

Department of Medical Biophysics, University of Toronto(多伦多大学医学生物物理学系);Physical Sciences Platform, Sunnybrook Research Institute(阳光医疗研究学院物理科学平台);UCL Cancer Institute, University College London(伦敦大学学院癌症研究所);Systems and Biomedical Engineering Department, Cairo University(开罗大学系统与生物医学工程系);Department of Surgery, University of Toronto(多伦多大学外科医学系);Department of Laboratory Medicine and Pathobiology, University of Toronto(多伦多大学实验室医学与病理学系);Sunnybrook Health Sciences Centre(阳光健康科学中心);Department of Medical Imaging, University of Toronto(多伦多大学医学影像学系)

Muhammad Alberb, Jianan Chen, Hossam El-rewaidy, Paul Karanicolas, Arun Seth, Yutaka Amemiya, Anne Martel, Helen Cheung

AI总结:

本研究提出了一种基于AI的自动化框架,利用术前MRI预测结直肠肝转移术后生存,结合分割算法和放射组学分析提高预测准确性。

摘要:

尽管结直肠肝转移(CRLM)可通过肝切除术潜在治愈,但患者预后仍然高度异质性。术后生存预测对于避免无益的手术并指导个性化治疗是必要的。在本研究中,我们提出了一种基于人工智能的自动化框架,用于利用术前和术后对比MRI进行术后CRLM生存预测。我们回顾性研究了227名在2013至2020年间接受根治性肝切除术前已进行胆影葡胺增强MRI的CRLM患者。我们开发了一个生存预测框架,包括一个具有解剖意识的分割管道,随后是放射组学管道。分割管道从部分标注的数据中学习肝脏、CRLMs和脾脏的分割,利用可提示的基础模型生成伪标签。为了支持这个管道,我们提出了SAMONAI,一种提示传播算法,将Segment Anything Model扩展到3D点基于分割。预测的术前和术后对比分割随后被输入我们的放射组学管道,该管道提取每个肿瘤的特征并使用SurvAMINN,一种基于自编码器的多实例神经网络进行时间到事件生存预测。SurvAMINN从右删失数据中联合学习降维和生存预测,强调高风险转移。我们通过单变量和多变量Cox回归将我们的框架与已建立的方法和生物标志物进行了比较。我们的分割管道实现了中位Dice分数为0.96(肝脏)和0.93(脾脏),驱动CRLM分割Dice分数为0.78和检测F1分数为0.79。精确的分割使我们的放射组学管道能够实现生存预测C-index为0.69。我们的结果表明,整合分割算法与基于放射组学的生存分析可以提供准确且自动的CRLM结果预测。

英文摘要:

While colorectal liver metastasis (CRLM) is potentially curable via hepatectomy, patient outcomes remain highly heterogeneous. Postoperative survival prediction is necessary to avoid non-beneficial surgeries and guide personalized therapy. In this study, we present an automated AI-based framework for postoperative CRLM survival prediction using pre- and post-contrast MRI. We performed a retrospective study of 227 CRLM patients who had gadoxetate-enhanced MRI prior to curative-intent hepatectomy between 2013 and 2020. We developed a survival prediction framework comprising an anatomy-aware segmentation pipeline followed by a radiomics pipeline. The segmentation pipeline learns liver, CRLMs, and spleen segmentation from partially-annotated data, leveraging promptable foundation models to generate pseudo-labels. To support this pipeline, we propose SAMONAI, a prompt propagation algorithm that extends Segment Anything Model to 3D point-based segmentation. Predicted pre- and post-contrast segmentations are then fed into our radiomics pipeline, which extracts per-tumor features and predicts survival using SurvAMINN, an autoencoder-based multiple instance neural network for time-to-event survival prediction. SurvAMINN jointly learns dimensionality reduction and survival prediction from right-censored data, emphasizing high-risk metastases. We compared our framework against established methods and biomarkers using univariate and multivariate Cox regression. Our segmentation pipeline achieves median Dice scores of 0.96 (liver) and 0.93 (spleen), driving a CRLM segmentation Dice score of 0.78 and a detection F1-score of 0.79. Accurate segmentation enables our radiomics pipeline to achieve a survival prediction C-index of 0.69. Our results show the potential of integrating segmentation algorithms with radiomics-based survival analysis to deliver accurate and automated CRLM outcome prediction.

机构、总结、中文摘要均由AI分析而来,可能存在错误,请以论文正文为准。

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