Prediction of clinically relevant postoperative pancreatic fistula using radiomic features and preoperative data

Research output: Contribution to journalResearch articleContributedpeer-review

Abstract

Clinically relevant postoperative pancreatic fistula (CR-POPF) can significantly affect the treatment course and outcome in pancreatic cancer patients. Preoperative prediction of CR-POPF can aid the surgical decision-making process and lead to better perioperative management of patients. In this retrospective study of 108 pancreatic head resection patients, we present risk models for the prediction of CR-POPF that use combinations of preoperative computed tomography (CT)-based radiomic features, mesh-based volumes of annotated intra- and peripancreatic structures and preoperative clinical data. The risk signatures were evaluated and analysed in detail by visualising feature expression maps and by comparing significant features to the established CR-POPF risk measures. Out of the risk models that were developed in this study, the combined radiomic and clinical signature performed best with an average area under receiver operating characteristic curve (AUC) of 0.86 and a balanced accuracy score of 0.76 on validation data. The following pre-operative features showed significant correlation with outcome in this signature (p< 0.05) - texture and morphology of the healthy pancreatic segment, intensity volume histogram-based feature of the pancreatic duct segment, morphology of the combined segment, and BMI. The predictions of this pre-operative signature showed strong correlation (Spearman correlation co-efficient, ρ= 0.7) with the intraoperative updated alternative fistula risk score (ua-FRS), which is the clinical gold standard for intraoperative CR-POPF risk stratification. These results indicate that the proposed combined radiomic and clinical signature developed solely based on preoperatively available clinical and routine imaging data can perform on par with the current state-of-the-art intraoperative models for CR-POPF risk stratification.

Details

Original languageEnglish
Article number7506
JournalScientific reports
Volume13
Issue number1
Publication statusPublished - Dec 2023
Peer-reviewedYes

External IDs

PubMed 37161007
ORCID /0000-0002-7017-3738/work/146646036
WOS 001037834400043
ORCID /0000-0002-2666-8776/work/150883447
ORCID /0000-0003-2265-4809/work/150884441

Keywords

Research priority areas of TU Dresden

Subject groups, research areas, subject areas according to Destatis

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • External validation, Pancreaticoduodenectomy, Risk score, Somatostatin analogs, Pancreas/diagnostic imaging, Pancreatic Neoplasms/diagnostic imaging, Humans, Pancreatic Fistula/diagnostic imaging, Postoperative Complications/diagnostic imaging, Retrospective Studies