Development and multicenter validation of a novel radiomics-based model for identifying eosinophilic chronic rhinosinusitis with nasal polyps

Abstract

BACKGROUND: Reliable noninvasive methods are needed to identify endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) to facilitate personalized therapy. Previous computed tomography (CT) scoring system has limited and inconsistent performance in identifying eosinophilic CRSwNP. We aimed to develop and validate a radiomics-based model to identify eosinophilic CRSwNP. METHODS: Surgical patients with CRSwNP were recruited from Tongji Hospital and randomly divided into training (n = 232) and internal validation cohort (n = 61). Patients from two additional hospitals served as external validation cohort-1 (n = 84) and cohort-2 (n = 54), respectively. Data were collected from October 2013 to May 2021. Eosinophilic CRSwNP was determined by histological criterion. The least absolute shrinkage and selection operator and the logistic regression (LR) algorithm were used to develop a radiomics model. Univariate and multivariate LR were employed to build models based on CT scores, clinical characteristics, and the combination of radiological and clinical characteristics. Model performance was evaluated by assessing discrimination, calibration, and clinical utility. RESULTS: The radiomics model based on 10 radiomic features achieved an area under the curve (AUC) of 0.815 in the training cohort, significantly better than the CT score model based on ethmoid-to-maxillary sinus score ratio with an AUC of 0.655. The combination of radiomic features and blood eosinophil count had a further improved performance, achieving an AUC of 0.903. The performance of these models was confirmed in all validation cohorts with satisfying predictive calibration and clinical application value. CONCLUSIONS: A CT radiomics-based model is promising to identify eosinophilic CRSwNP. This radiomics-based method may provide novel insights in solving other clinical concerns, such as guiding personalized treatment and predicting prognosis in patients with CRSwNP.

Hyperuricemia Increases the Risk of Postoperative Recurrence in Chinese Patients with Chronic Rhinosinusitis

“…Accordingly, severe infiltration of inflammatory cells in sinonasal mucosa, excessive proinflammatory cytokine accumulation, and tissue remodeling were regarded as the major pathogenetic mechanisms in the recurrent CRS. 41 , 42 It was worth noting that uric acid pathway activation could promote innate cytokine production and group 2 innate lymphoid cell (ILC2s) accumulation, which contributed to aggravating Th2 immune responses. 43 , 44 Emerging evidence has suggested that hyperuricemia can increase oxidative stress levels within the airway mucosa, leading to increased generation of free radicals, which in turn may trigger inflammatory responses, epithelial-mesenchymal transition, and tissue remodeling.…”

Serum proteomics identify CSF1R as a novel biomarker for postoperative recurrence in chronic rhinosinusitis with nasal polyps

“… 45 Simultaneously, it amplifies eosinophilic inflammation by recruiting and facilitating the migration of eosinophils into tissues. 46 , 47 To explore the role of CSF1R in driving M2 polarization and its association with CRSwNP recurrence, we conducted an overexpression of CSF1R in macrophages. We observed that up-regulation of CSF1R enhanced macrophage M2 polarization and secretion of IL-12 and TGF-β1.…”

Serum Proteomic Analysis Revealed Biomarkers for Eosinophilic Chronic Rhinosinusitis with Nasal Polyps Pathophysiology

“…Its diagnosis primarily relies on pathological tissue section examination and eosinophil count, which is invasive and subject to certain subjectivity. 34 , 35 Although previous studies have identified several potential biomarkers for predicting eCRSwNP, such as serum metabolomics, 36 nasal microbiota, 37 and the peripheral blood lymphocyte-to-eosinophil ratio, 38 their sensitivity and specificity remain relatively constrained, hindering their adoption in clinical settings. Therefore, the exploration of objective biomarkers for eCRSwNP is still a current research focus, which will contribute to achieving personalized precision treatment.…”