Development and validation of nomograms by radiomic features on ultrasound imaging for predicting overall survival in patients with primary nodal diffuse large B-cell lymphoma

Abstract

ObjectivesTo develop and validate a nomogram to predict the overall survival (OS) of patients with primary nodal diffuse large B-cell lymphoma(N-DLBCL) based on radiomic features and clinical features.Materials and methodsA retrospective analysis was performed on 145 patients confirmed with N-DLBCL and they were randomly assigned to training set(n=78), internal validation set(n=33), external validation set(n=34). First, a clinical model (model 1) was established according to clinical features and ultrasound (US) results. Then, based on the radiomics features extracted from conventional ultrasound images, a radiomic signature was constructed (model 2), and the radiomics score (Rad-Score) was calculated. Finally, a comprehensive model was established (model 3) combined with Rad-score and clinical features. Receiver operating characteristic (ROC) curves were employed to evaluate the performance of model 1, model 2 and model 3. Based on model 3, we plotted a nomogram. Calibration curves were used to test the effectiveness of the nomogram, and decision curve analysis (DCA) was used to asset the nomogram in clinical use.ResultsAccording to multivariate analysis, 3 clinical features and Rad-score were finally selected to construct the model 3, which showed better predictive value for OS in patients with N-DLBCL than mode 1 and model 2 in training (AUC,0. 891 vs. 0.779 vs.0.756), internal validation (AUC, 0.868 vs. 0.713, vs.0.756) and external validation (AUC, 914 vs. 0.866, vs.0.789) sets. Decision curve analysis demonstrated that the nomogram based on model 3 was more clinically useful than the other two models.ConclusionThe developed nomogram is a useful tool for precisely analyzing the prognosis of N-DLBCL patients, which could help clinicians in making personalized survival predictions and assessing individualized clinical options.

Establishment and evaluation of a nomogram for predicting the survival outcomes of patients with diffuse large B-cell lymphoma based on International Prognostic Index scores and clinical indicators

“…Patients with DLBCL differ in terms of their morphologic, immunophenotypic, clinical, and genetic features, and this heterogeneity underlies their different responses to chemotherapy regimens ( 2 ). Previously, the standard first-line treatment was cyclophosphamide, adriamycin, vincristine, and prednisone (CHOP), but more recent studies have shown that the addition of rituximab to CHOP (R-CHOP) decreases the risk of early and late recurrence ( 3 , 4 ). Subsequent clinical study reported that R-CHOP cures >50% of DLBCL patients, and this regimen is now accepted as a standard first-line treatment for DLBCL ( 5 ).…”

An integrated radiomics nomogram based on conventional ultrasound improves discriminability between fibroadenoma and pure mucinous carcinoma in breast

“…Preoperative core needle biopsy (CNB) is an invasive examination and could not reflect the pathology of masses entirely for the heterogeneity of tumors. Otherwise, CNB may lead to complications such as severe bleeding and infection ( 12 ). Therefore, it is important to seek a non-invasive method to identify P-MC and FA and help clinicians make accurate clinical decisions ( 13 , 14 ).…”