Magnetic Resonance Imaging–Based Radiomics Models to Predict Early Extrapancreatic Necrosis in Acute Pancreatitis

Abstract

The aim of the study was to investigate radiomics models based on magnetic resonance imaging (MRI) for predicting early extrapancreatic necrosis (EXPN) in acute pancreatitis.Methods: Radiomics features were extracted from T2-weighted images of extrapancreatic collections and late arterial-phase images of the pancreatic parenchyma for 135 enrolled patients (94 in the primary cohort, including 47 EXPN patients and 41 in the validation cohort, including 20 EXPN patients). The optimal features after dimension reduction were used for radiomics modeling through a support vector machine. A clinical model, the MR severity index score, and extrapancreatic inflammation on MRI were evaluated.Results: Twelve optimal features from the extrapancreatic collection images and 10 from the pancreatic parenchyma images were selected for modeling. The pancreatic parenchyma-based and extrapancreatic collection-based radiomics models showed good predictive accuracy in both the training and validation cohorts. The areas under the curve of the extrapancreatic collection-based radiomics model (0.969 and 0.976) were consistent with those of the pancreatic parenchyma-based model (0.931 and 0.921) for both cohorts and better than those of the clinical model and imaging scores for both cohorts. Conclusions:The MRI-based radiomics models of both the extrapancreatic collections and the pancreatic parenchyma had excellent predictive performance for early EXPN.

A systematic review of radiomics in pancreatitis: applying the evidence level rating tool for promoting clinical transferability

“…The conventional imaging features usually lag behind disease progression, which cannot help clinical decision-making. Current studies demonstrated the usefulness of radiomics in predicting severity, recurrence, progression, and extra-pancreatic necrosis [ 33 , 35 , 40 , 41 , 45 , 59 ]. However, the studies were conducted by varying imaging modalities concerning separate outcomes, which do not allow further meta-analysis to establish any evidence.…”

Evaluation of Inflammatory Infiltration in the Retroperitoneal Space of Acute Pancreatitis Using Computer Tomography and Its Correlation with Clinical Severity

“…It is generally believed that anatomically, the lymphatic plexus around the transverse septum is connected with the mediastinal and subcostal spaces, the giant inflammatory cells formed by AP spread into the mediastinum and subcostal space through the lymph plexus around the septum, and the pancreatic enzyme effusion containing soluble tissue gradually entered the chest cavity. PE is important for assessing the severity and prognosis of AP and is the main symptom of extrapancreatic involvement of AP [ 29 ]. Although PE can also be detected radiologically early, most of them occur earlier than the date of pancreatic injury, and the incidence of PE increases with increasing CTSI score [ 30 ].…”

Radiomics and Its Applications and Progress in Pancreatitis: A Current State of the Art Review

“…Zhou et al ( 20 ) used an MRI based radiomics model to predict early extrapancreatic necrosis (EXPN) in patients with AP. They enrolled 135 AP patients who were divided into the training ( n = 94, with 47 EXPN and 47 APFC patients) and validation cohorts ( n = 41, with 20 EXPN and 21 APFC patients).…”

“…They enrolled 135 AP patients who were divided into the training ( n = 94, with 47 EXPN and 47 APFC patients) and validation cohorts ( n = 41, with 20 EXPN and 21 APFC patients). On the T2WI and late arterial phase images, Zhou et al ( 20 ) extracted 350 image radiomics features from ROI of the peripancreatic collections (T2WI) and entire pancreatic parenchyma (late arterial phase). After dimension reduction and feature selection, 22 features (12 from the T2WI and 10 from the late arterial phase images) were selected for establishing SVM model.…”