Comparison of a Gd-EOB-DTPA-enhanced MRI radiomics model and ultrasound elastography in diagnosing non-significant liver fibrosisy

CAO Yan; XIE Shuangshuang; CHEN Yingxu; QIU Caixin; ZHAO Yumeng; YAO Shengjuan; SHEN Wen

doi:10.19300/j.2024.L21757

Abstract：Objective To compare the diagnostic performance of a gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI hepatobiliary phase radiomics model and ultrasound elastography(UE)in assessing non-significant liver fibrosis.Additionally,to investigate whether combining radiomics features with other parameters into a joint model can improve diagnostic efficiency.Methods This retrospective study included 201 patients with chronic liver disease from two hospitals who underwent both Gd-EOB-DTPA-enhanced MRI and UE.Patients were classified into non-significant and significant groups based on pathological results.The dataset was divided into a training set of 152 cases(38 non-significants,114 significants)and a test set of 49 cases(11 non-significants,38 significants)according to hospital origin.Clinical indicators with significant differences between the two groups were selected for logistic regression analysis to establish a clinical model.Liver stiffness measurement(LSM)values were obtained from UE.Radiomics features were extracted from hepatobiliary phase MRI images,and a radiomics model was developed using the least absolute shrinkage and selection operator(LASSO)regression algorithm with 10-fold cross-validation.A clinical-ultrasound combined model and a clinical-ultrasound-radiomics combined nomogram model were constructed.The performance of multiple models and parameter were sequentially analyzed using receiver operating characteristic(ROC)curves,and the performance differences were compared by DeLong test.Calibration curves were used to assess the consistency between predicted outcomes and actual pathological gradings.Decision curve analysis(DCA)was used to evaluate the clinical value of each model.Results In both the training and test sets,the diagnostic performance of the radiomics model,LSM,and clinical model for non-significant liver fibrosis was similar,with no statistically significant differences(all P>0.05).The diagnostic performance of the clinical-ultrasound combined model was higher than the clinical model and LSM(all P<0.05);the diagnostic performance of the clinical-ultrasound-radiomics combined nomogram model for diagnosing non-significant liver fibrosis was superior to the other models and LSM(all P<0.05).Calibration curves assessment showed good consistency between the predictions of the clinical-ultrasound-radiomics combined nomogram model and actual results,while DCA demonstrated that the nomogram model had the highest net benefit across a threshold probability range of 10%to 92%.Conclusion The diagnostic performance of the Gd-EOB-DTPA-enhanced MRI hepatobiliary phase radiomics model is comparable to the LSM from UE for non-significant liver fibrosis.However,combining multiple parameters into a joint model significantly improves diagnostic accuracy.