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Development and assessment of an individualized nomogram to predict colorectal cancer liver metastases.

Background
This article aims to develop and assess the radiomics paradigm for predicting colorectal cancer liver metastasis (CRLM) from the primary tumor.


Methods
This retrospective study included 100 patients from the First Hospital of Jilin University from June 2017 to December 2017. The 100 patients comprised 50 patients with and 50 without CRLM. The maximum-level enhanced computed tomography (CT) image of primary cancer in the portal venous phase of each patient was selected as the original image data. To automatically implement radiomics-related paradigms, we developed a toolkit called Radiomics Intelligent Analysis Toolkit (RIAT).


Results
With RIAT, the model based on logistic regression (LR) using both the radiomics and clinical information signatures showed the maximum net benefit. The area under the curve (AUC) value was 0.90±0.02 (sensitivity =0.85±0.02, specificity =0.79±0.04) for the training set, 0.86±0.11 (sensitivity =0.85±0.09, specificity =0.75±0.19) for the verification set, 0.906 (95% CI, 0.840-0.971; sensitivity =0.81, specificity =0.84) for the cross-validation set, and 0.899 (95% CI, 0.761-1.000; sensitivity =0.78, specificity =0.91) for the test set.


Conclusions
The radiomics nomogram-based LR with clinical risk and radiomics features allows for a more accurate classification of CRLM using CT images with RIAT.