Abstract
Purpose
Predicting nonalcoholic fatty liver disease (NAFLD) following pancreaticoduodenectomy (PD) is challenging, which delays therapeutic intervention and makes its prevention difficult. We conducted this study to assess the potential application of preoperative computed tomography (CT) radiomics for predicting NAFLD.
Methods
The subjects of this retrospective study were 186 patients with PD from a single institution. We extracted the predictors of NAFLD after PD statistically from conventional clinical and radiomic features of the estimated remnant pancreas and whole liver region on preoperative nonenhanced CT images. Based on these predictors, we developed a machine-learning predictive model, which integrated clinical and radiomic features. A comparative model used only clinical features as predictors.
Results
The incidence of NAFLD after PD was 43.5%. The variables of the clinicoradiomic model included one shape feature of the pancreas, two texture features of the liver, and sex; the variables of the clinical model were age, sex, and chemoradiotherapy. The accuracy%, precision%, recall%, F1 score, and area under the curve of the two models were 75.0, 72.7, 66.7, 69.6, and 0.80; and 69.6, 68.4, 54.2, 60.5, and 0.69, respectively.
Conclusions
Preoperative CT-derived radiomic features from the pancreatic and liver regions are promising for the prediction of NAFLD post-PD. Using these features enhances the predictive model, enabling earlier intervention for high-risk patients.
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Acknowledgements
We thank Hiroyuki Kawaguchi, B.S. in Radiological Technologist, and the other staff members of FUJIFILM Medical Co., Ltd. for their invaluable assistance and guidance in using the image analysis software, SYNAPSE VINCENT. Their expertise and dedicated support greatly enhanced the quality and accuracy of our research results, and we are grateful for their contributions.
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This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Takehiro Fujii was responsible for the study design and manuscript writing. Yusuke Iizawa collected the clinical data. The radiomics analysis of the images was performed by Takehiro Fujii and Takumi Kobayashi. All authors read and approved the final manuscript.
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Fujii, T., Iizawa, Y., Kobayashi, T. et al. Radiomics-based prediction of nonalcoholic fatty liver disease following pancreatoduodenectomy. Surg Today (2024). https://doi.org/10.1007/s00595-024-02822-0
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DOI: https://doi.org/10.1007/s00595-024-02822-0