Can Computed Tomography-Based Radiomics Potentially Discrimination Between Anterior Mediastinal Cysts and type B1 and B2 thymomas
Abstract Background Anterior mediastinal cysts (AMC) are often misdiagnosed as thymomas and undergo surgical resection, which caused unnecessary treatment and medical resources waste. The purpose of this study was to explore potential possibility of computed tomography (CT)-based radiomics for the diagnosis of AMC and type B1 and B2 thymomas. Methods A group of 188 patients with pathologically confirmed AMC (106 cases mischarged as thymomas in CT) and thymomas (82 cases) and underwent routine chest CT from January 2010 to December 2018 were retrospectively analyzed. The lesions were manually delineated using ITK-SNAP software, and radiomics features were performed using the Artificial Intelligence Kit (AK) software. A total of 396 tumor texture features were extracted from enhanced CT and unenhanced CT, respectively. The general test, correlation analysis and LASSO were used to features selection and then the radiomics signature (radscore) were obtained. The combined model including radscore and independent clinical factors were developed. The model performances were evaluated on discrimination, calibration curve. Results Two radscore model were constructed from the unenhanced and enhanced phases based on the selected 4 and 3 features, respectively. The AUC, sensitivity, and specificity of the enhanced radscore model were 0.928, 89.3% and 83.8% in the training dataset and 0.899, 84.6%, 87.5% in the test dataset (higher than the unenhanced radscore model). The combined model of enhanced CT including radiomics features and independent clinical factors yielded an AUC, sensitivity and specificity of 0.941, 82.1%, and 94.6% in the training dataset and 0.938, 92.3%, and 87.5% in the test dataset (higher than the unenhanced combined model and enhanced radscore model). Conclusions The study suggested the possibility that the combined model in enhanced CT provided a potential tool to facilitate the differential diagnosis of AMC and type B1 and B2 thymomas.