Prediction of histological grade using preoperative multi-sequence MRI-based radiomics signature in patients with non-small-cell lung cancer

Abstract

Background: Non-small cell lung cancer (NSCLC) is treatable when caught early, yet limited non-invasive methods exist for grading NSCLC patients. In the present study, we aimed to examine the diagnostic utility of multi-sequence magnetic resonance imaging (MRI) radiomics and clinical features for grading NSCLC. Methods: In this retrospective study, 148 patients with postoperative pathologically-confirmed NSCLC were recruited. Both preoperative T2-weighted imaging (T2WI) and multi-b-value diffusion-weighted imaging (DWI) were performed on a 1.5 T MRI scanner. A total of 2775 radiomics features were extracted from the T2WI, DWI, and the corresponding apparent diffusion coefficient (ADC) maps of patients. The least absolute shrinkage and selection operator (LASSO) and stepwise regression method were used for feature selection using the training cohort (n=110). Next, these features were further evaluated assessed in the two cohorts using a non-linear support vector machine (SVM) classifier. Lastly, a Radscore model was used to develop the radiomics-clinical nomogram.Results: Favorable discrimination performance was obtained for five of the optimal features using both cohorts, as demonstrated by the area under the curves (AUC) of 0.761 and 0.753. In addition, the radiomics-clinical nomogram, which integrated the Radscore with four independent clinical predictors, showed higher discriminative power, with AUCs of 0.814 and 0.767 for the X.T cohort and H.Y cohort, respectively. The nomogram showed excellent predictive performance and potential clinical utility for grading NSCLC.Conclusions: Multi-sequence MRI radiomics features can stratify NSCLC tumor grades noninvasively. The radiomics features can be integrated with the clinical features to improve its predictive performance.