Deep learning model combined with computed tomography features to preoperatively predicting the risk stratification of gastrointestinal stromal tumors

Yi Li; Yan-Bei Liu; Xu-Bin Li; Xiao-Nan Cui; Dong-Hua Meng; Cong-Cong Yuan; Zhao-Xiang Ye

doi:10.4251/wjgo.v16.i12.4663

Deep learning model combined with computed tomography features to preoperatively predicting the risk stratification of gastrointestinal stromal tumors

World J Gastrointest Oncol. 2024 Dec 15;16(12):4663-4674. doi: 10.4251/wjgo.v16.i12.4663.

Authors

Yi Li¹, Yan-Bei Liu², Xu-Bin Li¹, Xiao-Nan Cui¹, Dong-Hua Meng¹, Cong-Cong Yuan³, Zhao-Xiang Ye⁴

Affiliations

¹ Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Tianjin 300060, China.
² School of Life Sciences, Tiangong University, Tianjin 300387, China.
³ Department of Radiology, Tianjin First Central Hospital, Tianjin 300190, China.
⁴ Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine, Tianjin Key Laboratory of Digestive Cancer, Tianjin 300060, China. yezhaoxiang@163.com.

Abstract

Background: Gastrointestinal stromal tumors (GIST) are prevalent neoplasm originating from the gastrointestinal mesenchyme. Approximately 50% of GIST patients experience tumor recurrence within 5 years. Thus, there is a pressing need to accurately evaluate risk stratification preoperatively.

Aim: To assess the application of a deep learning model (DLM) combined with computed tomography features for predicting risk stratification of GISTs.

Methods: Preoperative contrast-enhanced computed tomography (CECT) images of 551 GIST patients were retrospectively analyzed. All image features were independently analyzed by two radiologists. Quantitative parameters were statistically analyzed to identify significant predictors of high-risk malignancy. Patients were randomly assigned to the training (n = 386) and validation cohorts (n = 165). A DLM and a combined DLM were established for predicting the GIST risk stratification using convolutional neural network and subsequently evaluated in the validation cohort.

Results: Among the analyzed CECT image features, tumor size, ulceration, and enlarged feeding vessels were identified as significant risk predictors (P < 0.05). In DLM, the overall area under the receiver operating characteristic curve (AUROC) was 0.88, with the accuracy (ACC) and AUROCs for each stratification being 87% and 0.96 for low-risk, 79% and 0.74 for intermediate-risk, and 84% and 0.90 for high-risk, respectively. The overall ACC and AUROC were 84% and 0.94 in the combined model. The ACC and AUROCs for each risk stratification were 92% and 0.97 for low-risk, 87% and 0.83 for intermediate-risk, and 90% and 0.96 for high-risk, respectively. Differences in AUROCs for each risk stratification between the two models were significant (P < 0.05).

Conclusion: A combined DLM with satisfactory performance for preoperatively predicting GIST stratifications was developed using routine computed tomography data, demonstrating superiority compared to DLM.

Keywords: Deep learning; Gastrointestinal stromal tumors; Prognosis; Risk stratification; Tomography, X-ray computed.