• J Magn Reson Imaging · Feb 2020

    Multicenter Study

    Radiomics nomogram based on MRI for predicting white matter hyperintensity progression in elderly adults.

    • Zhen-Yu Shu, Yuan Shao, Yu-Yun Xu, Qin Ye, Si-Jia Cui, De-Wang Mao, Pei-Pei Pang, and Xiang-Yang Gong.
    • Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China.
    • J Magn Reson Imaging. 2020 Feb 1; 51 (2): 535-546.

    BackgroundWhite matter hyperintensity (WMH) is widely observed in aging brain and is associated with various diseases. A pragmatic and handy method in the clinic to assess and follow up white matter disease is strongly in need.PurposeTo develop and validate a radiomics nomogram for the prediction of WMH progression.Study TypeRetrospective.PopulationBrain images of 193 WMH patients from the Picture Archiving and Communication Systems (PACS) database in the A Medical Center (Zhejiang Provincial People's Hospital). MRI data of 127 WMH patients from the PACS database in the B Medical Center (Zhejiang Lishui People's Hospital) were included for external validation. All of the patients were at least 60 years old.Field Strength/SequenceT1 -fluid attenuated inversion recovery images were acquired using a 3T scanner.AssessmentWMH was evaluated utilizing the Fazekas scale based on MRI. WMH progression was assessed with a follow-up MRI using a visual rating scale. Three neuroradiologists, who were blinded to the clinical data, assessed the images independently. Moreover, interobserver and intraobserver reproducibility were performed for the regions of interest for segmentation and feature extraction.Statistical TestsA receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ROC was calculated, along with sensitivity and specificity. Also, a Hosmer-Lemeshow test was performed.ResultsThe AUC of radiomics signature in the primary, internal validation cohort, external validation cohort were 0.886, 0.816, and 0.787, respectively; the specificity were 71.79%, 72.22%, and 81%, respectively; the sensitivity were 92.68%, 87.94% and 78.3%, respectively. The radiomics nomogram in the primary cohort (AUC = 0.899) and the internal validation cohort (AUC = 0.84). The Hosmer-Lemeshow test showed no significant difference between the primary cohort and the internal validation cohort (P > 0.05). The AUC of the radiomics nomogram, radiomics signature, and hyperlipidemia in all patients from the primary and internal validation cohort was 0.878, 0.848, and 0.626, respectively.Data ConclusionThis multicenter study demonstrated the use of a radiomics nomogram in predicting the progression of WMH with elderly adults (an age of at least 60 years) based on conventional MRI.Level Of Evidence3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:535-546.© 2019 International Society for Magnetic Resonance in Medicine.

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