Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer

Abstract To develop and validate artificial intelligence models based on contrast-enhanced CT(CECT) images of venous phase using deep learning (DL) and Radiomics approaches to predict lymphovascular invasion in gastric cancer prior to surgery. We retrospectively analyzed data from 351 gastric cancer...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiao Sun, Pei Wang, Rui Ding, Li Ma, Huairong Zhang, Li Zhu
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-11427-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849766254131281920
author Xiao Sun
Pei Wang
Rui Ding
Li Ma
Huairong Zhang
Li Zhu
author_facet Xiao Sun
Pei Wang
Rui Ding
Li Ma
Huairong Zhang
Li Zhu
author_sort Xiao Sun
collection DOAJ
description Abstract To develop and validate artificial intelligence models based on contrast-enhanced CT(CECT) images of venous phase using deep learning (DL) and Radiomics approaches to predict lymphovascular invasion in gastric cancer prior to surgery. We retrospectively analyzed data from 351 gastric cancer patients, randomly splitting them into two cohorts (training cohort, n = 246; testing cohort, n = 105) in a 7:3 ratio. The tumor region of interest (ROI) was outlined on venous phase CT images as the input for the development of radiomics, 2D and 3D DL models (DL2D and DL3D). Of note, by centering the analysis on the tumor’s maximum cross-section and incorporating seven adjacent 2D images, we generated stable 2.5D data to establish a multi-instance learning (MIL) model. Meanwhile, the clinical and feature-combined models which integrated traditional CT enhancement parameters (Ratio), radiomics, and MIL features were also constructed. Models’ performance was evaluated by the area under the curve (AUC), confusion matrices, and detailed metrics, such as sensitivity and specificity. A nomogram based on the combined model was established and applied to clinical practice. The calibration curve was used to evaluate the consistency between the predicted LVI of each model and the actual LVI of gastric cancer, and the decision curve analysis (DCA) was used to evaluate the net benefit of each model. Among the developed models, 2.5D MIL and combined models exhibited the superior performance in comparison to the clinical model, the radiomics model, the DL2D model, and the DL3D model as evidenced by the AUC values of 0.820, 0.822, 0.748, 0.725, 0.786, and 0.711 on testing set, respectively. Additionally, the 2.5D MIL and combined models also showed good calibration for LVI prediction, and could provide a net clinical benefit when the threshold probability ranged from 0.31 to 0.98, and from 0.28 to 0.84, indicating their clinical usefulness. The MIL and combined models highlight their performance in predicting preoperative lymphovascular invasion in gastric cancer, offering valuable insights for clinicians in selecting appropriate treatment options for gastric cancer patients.
format Article
id doaj-art-7cd0b313d12044bab8fc5f1bf5a1b534
institution DOAJ
issn 2045-2322
language English
publishDate 2025-07-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-7cd0b313d12044bab8fc5f1bf5a1b5342025-08-20T03:04:38ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-11427-7Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancerXiao Sun0Pei Wang1Rui Ding2Li Ma3Huairong Zhang4Li Zhu5Department of Radiology, General Hospital of Ningxia Medical UniversityDepartment of Radiology, General Hospital of Ningxia Medical UniversityDepartment of Radiology, General Hospital of Ningxia Medical UniversityDepartment of Radiology, General Hospital of Ningxia Medical UniversityDepartment of Radiology, General Hospital of Ningxia Medical UniversityDepartment of Radiology, General Hospital of Ningxia Medical UniversityAbstract To develop and validate artificial intelligence models based on contrast-enhanced CT(CECT) images of venous phase using deep learning (DL) and Radiomics approaches to predict lymphovascular invasion in gastric cancer prior to surgery. We retrospectively analyzed data from 351 gastric cancer patients, randomly splitting them into two cohorts (training cohort, n = 246; testing cohort, n = 105) in a 7:3 ratio. The tumor region of interest (ROI) was outlined on venous phase CT images as the input for the development of radiomics, 2D and 3D DL models (DL2D and DL3D). Of note, by centering the analysis on the tumor’s maximum cross-section and incorporating seven adjacent 2D images, we generated stable 2.5D data to establish a multi-instance learning (MIL) model. Meanwhile, the clinical and feature-combined models which integrated traditional CT enhancement parameters (Ratio), radiomics, and MIL features were also constructed. Models’ performance was evaluated by the area under the curve (AUC), confusion matrices, and detailed metrics, such as sensitivity and specificity. A nomogram based on the combined model was established and applied to clinical practice. The calibration curve was used to evaluate the consistency between the predicted LVI of each model and the actual LVI of gastric cancer, and the decision curve analysis (DCA) was used to evaluate the net benefit of each model. Among the developed models, 2.5D MIL and combined models exhibited the superior performance in comparison to the clinical model, the radiomics model, the DL2D model, and the DL3D model as evidenced by the AUC values of 0.820, 0.822, 0.748, 0.725, 0.786, and 0.711 on testing set, respectively. Additionally, the 2.5D MIL and combined models also showed good calibration for LVI prediction, and could provide a net clinical benefit when the threshold probability ranged from 0.31 to 0.98, and from 0.28 to 0.84, indicating their clinical usefulness. The MIL and combined models highlight their performance in predicting preoperative lymphovascular invasion in gastric cancer, offering valuable insights for clinicians in selecting appropriate treatment options for gastric cancer patients.https://doi.org/10.1038/s41598-025-11427-7Lymphovascular invasionGastric cancerDeep learningRadiomicsTomography (X-ray computed)
spellingShingle Xiao Sun
Pei Wang
Rui Ding
Li Ma
Huairong Zhang
Li Zhu
Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer
Scientific Reports
Lymphovascular invasion
Gastric cancer
Deep learning
Radiomics
Tomography (X-ray computed)
title Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer
title_full Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer
title_fullStr Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer
title_full_unstemmed Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer
title_short Preoperative prediction value of 2.5D deep learning model based on contrast-enhanced CT for lymphovascular invasion of gastric cancer
title_sort preoperative prediction value of 2 5d deep learning model based on contrast enhanced ct for lymphovascular invasion of gastric cancer
topic Lymphovascular invasion
Gastric cancer
Deep learning
Radiomics
Tomography (X-ray computed)
url https://doi.org/10.1038/s41598-025-11427-7
work_keys_str_mv AT xiaosun preoperativepredictionvalueof25ddeeplearningmodelbasedoncontrastenhancedctforlymphovascularinvasionofgastriccancer
AT peiwang preoperativepredictionvalueof25ddeeplearningmodelbasedoncontrastenhancedctforlymphovascularinvasionofgastriccancer
AT ruiding preoperativepredictionvalueof25ddeeplearningmodelbasedoncontrastenhancedctforlymphovascularinvasionofgastriccancer
AT lima preoperativepredictionvalueof25ddeeplearningmodelbasedoncontrastenhancedctforlymphovascularinvasionofgastriccancer
AT huairongzhang preoperativepredictionvalueof25ddeeplearningmodelbasedoncontrastenhancedctforlymphovascularinvasionofgastriccancer
AT lizhu preoperativepredictionvalueof25ddeeplearningmodelbasedoncontrastenhancedctforlymphovascularinvasionofgastriccancer