Abstract
Purpose
The purpose of our study is to propose a preoperative computer-aided diagnosis system based on a radiomics method to differentiate gastrointestinal stromal tumors (GISTs) of the higher-risk group (HRG) from those of the lower-risk group (LRG) on endoscopic ultrasound (EUS) images.
Materials and method
Gastro-EUS (G-EUS) images of four different risk level GISTs were collected from 19 hospitals. The datasheet included 168 case HRG GISTs and 747 case LRG GISTs. A radiomics method with image segmentation, feature extraction, feature selection and classification was developed. Here 439 radiomics features were firstly extracted, and then, the least absolute shrinkage selection operator (lasso) model with a tenfold cross-validation and 31 bootstraps was used to reduce the dimension of feature sets. Finally, random forest was applied to establish the classification model.
Results
The proposed model differentiated 32 case HRG GISTs from 149 case LRG GISTs. Result for the testing set achieved the area under the receiver operating characteristic curve of 0.839, the accuracy of 0.823, the sensitivity of 0.813 and the specificity of 0.826.
Conclusion
The model could increase preoperative diagnostic accuracy and provide a valuable reference for the doctors.
Similar content being viewed by others
References
Demetri G, DeVita L, Lawrence TS, Rosenberg SA (2011) DeVita, Hellman, and Rosenberg’s cancer: principles and practice of oncology, 10th edn. Wolters Kluer, Alphen aan den Rijn
Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O’Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33:459–465
Miettinen M, Sobin LH, Lasota J (2005) Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol 29:52–68
Xu J, Ling TL, Wang M, Zhao WY, Cao H (2015) Preoperative imatinib treatment in patients with advanced gastrointestinal stromal tumors: patient experiences and systematic review of 563 patients. Int Surg 100(5):860–869
Agaimy A (2010) Review article: gastrointestinal stromal tumors (GIST) from risk stratification systems to the new TNM proposal: more questions than answers? A review emphasizing the need for a standardized GIST reporting. Int J Clin Exp Pathol 3(5):461–471
Blackstein ME, Blay JY, Corless C, Driman DK, Riddell R, Soulières D, Swallow CJ, Verma S (2006) Gastrointestinal stromal tumours: consensus statement on diagnosis and treatment. Can J Gastroenterol 20:157–163
Hwang JH, Rulyak SD, Kimmey MB (2006) American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses. Gastroenterology 130:2217–2228
NCCN guideline for soft tissue sarcoma (2012) Available from: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#sarcoma
Aerts HJ, Velazquez ER, Leijenaar RT, Parmar C, Grossmann P, Carvalho S, Bussink J, Monshouwer R, Haibe-Kains B, Rietveld D, Hoebers F, Rietbergen MM, Leemans R, Dekker A, Quackenbush J, Gillies RJ, Lambin P (2014) Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 5:4006–4015
Gillies RJ, Kinahan PE, Hricak H (2015) Radiomics: images are more than pictures, they are data. Radiology 278:563–577
Guo Y, Hu Y, Qiao M, Wang Y, Yu J, Li J, Chang C (2018) Radiomics analysis on ultrasound for prediction of biologic behavior in breast invasive ductal carcinoma. Clin Breast Cancer 18(3):e335–e344
Tibshirani R (1996) Regression shrinkage and selection via the lasso. J R Stat Soc Ser B (Methodol) 58(1):267–288
Santosa F, Symes WW (1986) Linear inversion of band-limited reflection seismograms. SIAM J Sci Stat Comput 7(4):1307–1330
Blom G, Holst L, Sandell D (1994) Problems and snapshots from the world of probability. Springer, New York
Yu J, Shi Z, Lian Y, Li Z, Liu T, Gao Y, Wang Y, Chen L, Mao Y (2016) Noninvasive IDH1 mutation estimation based on a quantitative radiomics approach for grade II glioma. Eur Radiol 27(8):3509–3522
Saito T, Rehmsmeier M (2015) The precision-recall plot is more informative than the ROC plot when evaluating binary classifiers on imbalanced datasets. PLoS ONE 10(3):e0118432
Acknowledgements
This work was supported by the National Natural Science Foundation of China (Grants 61871135 and 81830058) and the Science and Technology Commission of Shanghai Municipality (Grant 18511102904).
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Conflict of interest
We have no conflict of interest to declare.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Declaration of Helsinki. For retrospective study, formal consent is not required. Informed consent was obtained from all individual participants included in the study. This study has been approved by the Ethics Committee of the Changhai Hospital.
Rights and permissions
About this article
Cite this article
Li, X., Jiang, F., Guo, Y. et al. Computer-aided diagnosis of gastrointestinal stromal tumors: a radiomics method on endoscopic ultrasound image. Int J CARS 14, 1635–1645 (2019). https://doi.org/10.1007/s11548-019-01993-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11548-019-01993-3