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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 |
doi: 10.3389/fonc.2025.1525835
A CT-based radiomics nomogram for the preoperative prediction of perineural invasion in pancreatic ductal adenocarcinoma
Provisionally accepted- West China Hospital, Sichuan University, Chengdu, China
Purpose: To develop a nomogram based on CT radiomics features for preoperative prediction of perineural invasion (PNI) in pancreatic ductal adenocarcinoma (PDAC) patients.: A total of 217 patients with histologically confirmed PDAC were enrolled in this retrospective study. Radiomics features were extracted from the whole tumor. Univariate analysis, least absolute shrinkage and selection operator and logistic regression were applied for feature selection and radiomics model construction. Finally, a nomogram combining the radiomics score (Rad-score) and clinical characteristics was established. Receiver operating characteristic curve analysis, calibration curve analysis and decision curve analysis (DCA) were used to evaluate the predictive performance of the nomogram. Results: According to multivariate analysis, CT features, including the radiologists evaluation evaluated of radiologists regarding PNI status based on CECT (CTPNI) (OR=0.315 [95% CI: 0.131, 0.761], P=0.01), the lymph node status determined on CECT (CTLN) (OR=0.169 [95% CI: 0.059, 0.479], P=0.001) and the Rad-score 3 (OR=3.666 [95% CI: 2.069, 6.494], P<0.001), were significantly associated with PNI. The area under the receiver operating characteristic curve (AUC) for the nomogram combined with the Rad-score, CTLN and CTPNI achieved favorable discrimination of PNI status, with AUCs of 0.846 and 0.778 in the training and testing cohorts, respectively, which were superior to those of the Rad-score (AUC of 0.720 in the training cohort and 0.640 in the testing cohort) and CTPNI (AUC of 0.610 in the training cohort and 0.675 in the testing cohort). The calibration plot and decision curve showed good results. Conclusion: The CT-based radiomics nomogram has the potential to accurately predict PNI in patients with PDAC.
Keywords: Pancreatic Ductal Adenocarcinoma, Perineural invasion, computed tomography, Radiomics, nomogram
Received: 10 Nov 2024; Accepted: 06 Feb 2025.
Copyright: © 2025 Deng, Yu, Duan, Liu, Huang and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zixing Huang, West China Hospital, Sichuan University, Chengdu, China
Bin Song, West China Hospital, Sichuan University, Chengdu, China
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