Diagnostic and Interventional Radiology
Artificial Intelligence and Informatics - Original Article

Value of contrast-enhanced CT based radiomic machine learning algorithm in differentiating gastrointestinal stromal tumors with KIT exon 11 mutation: a two-center study

1.

Department of Colorectal Surgery, the Affiliated Hospital of Qingdao University (Pingdu), Shandong, China

2.

The Qingdao Grand International School, Shandong, China

3.

Department of Radiology, the Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China

4.

Department of Pathology, Shandong, China

Diagn Interv Radiol 2022; 28: 29-38
DOI: 10.5152/dir.2021.21600
Read: 503 Downloads: 194 Published: 01 January 2022

PURPOSE 
Knowing the genetic phenotype of gastrointestinal stromal tumors (GISTs) is essential for patients who receive therapy with tyrosine kinase inhibitors. The aim of this study was to develop a radiomic algorithm for predicting GISTs with KIT exon 11 mutation. 

METHODS
We enrolled 106 patients (80 in the training set, 26 in the validation set) with clinicopathologically confirmed GISTs from two centers. Preoperative and postoperative clinical characteristics were selected and analyzed to construct the clinical model. Arterial phase, venous phase, delayed phase, and tri-phase combined radiomics algorithms were generated from the training set based on contrast-enhanced computed tomography (CE-CT) images. Various radiomics feature selection methods were used, namely least absolute shrinkage and selection operator (LASSO); minimum redundancy maximum relevance (mRMR); and generalized linear model (GLM) as a machine-learning classifier. Independent predictive factors were determined to construct preoperative and postoperative radiomics nomograms by multivariate logistic regression analysis. The performances of the clinical model, radiomics algorithm, and radiomics nomogram in distinguishing GISTs with the KIT exon 11 mutation were evaluated by area under the curve (AUC) of the receiver operating characteristics.

RESULTS
Of 106 patients who underwent genetic analysis, 61 had the KIT exon 11 mutation.  The combined radiomics algorithm was found to be the best prediction model for differentiating the expression status of the KIT exon 11 mutation (AUC = 0.836; 95% confidence interval [CI], 0.640-0.951) in the validation set. The clinical model, and preoperative and postoperative radiomics nomograms had AUCs of 0.606 (95% CI, 0.397-0.790), 0.715 (95% CI, 0.506-0.873), and 0.679 (95% CI, 0.468-0.847), respectively, with the validation set.

CONCLUSION
The radiomics algorithm could distinguish GISTs with the KIT exon 11 mutation based on CE-CT images and could potentially be used for selective genetic analysis to support the precision medicine of GISTs. 

You may cite this article as: Liu B, Liu H, Zhang L, et al. Value of contrast-enhanced CT based radiomic machine learning algorithm in differentiating gastrointestinal stromal tumors with KIT exon 11 mutation: a two-center study. Diagn Interv Radiol. 2022;28(1):29-38.

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