Abstract
Background
To develop CT radiomics model based on different organs to predict rebleeding within 1 year after endoscopic treatment of esophageal and gastric varices (EGVs). The aim is to guide clinicians to provide effective secondary prophylaxis to cirrhotic patients in a timely manner to prevent rebleeding.
Methods
123 patients were enrolled and divided into rebleeding (n = 44) and non-bleeding group (n = 79). The liver, spleen, and the lower part of the esophagus were segmented and the extracted radiomics features were selected to construct liver/spleen/esophagus radiomics signatures based on logistic regression. Clinic-radiomics combined models and multi-organ combined radiomics models were constructed based on independent model scores using logistic regression. The model performance was evaluated by ROC analysis, calibration and decision curves. The continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices were analyzed .
Results
The clinical-liver combined model had the highest AUC of 0.931 (95% CI: 0.887–0.974), which was followed by the liver-based model with AUC of 0.891 (95% CI: 0.835–0.74). The decision curves also showed that the clinical-liver combined model afforded a greater net benefit compared to other models within the threshold probability of 0.45 to 0.80. Significant improvements in discrimination (IDI, P < 0.05) and reclassification (NRI, P < 0.05) were obtained for clinical-liver combined model compared with the independent ones.
Conclusion
The independent and combined liver-based CT radiomics models performed well in predicting rebleeding within 1 year after endoscopic treatment of EGVs.