Sub-regional radiomics combining multichannel 2-dimensional or 3-dimensional deep learning for predicting neoadjuvant chemo-immunotherapy response in esophageal squamous cell carcinoma: a multicenter study

Abstract This study aimed to develop and compare fusion models combining sub-regional radiomics with multichannel 2D and 3D DL to predict pCR in patients with LA-ESCC undergoing NACI. A total of 271 patients from three hospitals were divided into training, internal validation, and external validatio...

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Main Authors: Jiahao Zhu, Benjie Xu, Tiantian Fan, Shengjun Ji, Ke Gu, Jiaxuan Ding, Haibo Lu, Jianqun Ma, Yang Zhou
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:npj Precision Oncology
Online Access:https://doi.org/10.1038/s41698-025-01047-9
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Summary:Abstract This study aimed to develop and compare fusion models combining sub-regional radiomics with multichannel 2D and 3D DL to predict pCR in patients with LA-ESCC undergoing NACI. A total of 271 patients from three hospitals were divided into training, internal validation, and external validation cohorts. Tumor sub-regions were identified using K-means clustering based on radiomic features, and predictive features were extracted using PyRadiomics. Among all models, the DLRad1 model (radiomics + 2D DL) demonstrated the highest performance, with an AUC ranging from 0.793 to 0.910 across cohorts. Sub-region 1 features alone achieved an AUC of 0.823, while DLRad2 (radiomics + 3D DL) and other single-modality models showed lower AUCs (0.701–0.906). Spearman correlation analysis confirmed low redundancy among selected features. These findings support DLRad1 as a promising non-invasive tool to identify LA-ESCC patients most likely to benefit from NACI, potentially aiding personalized treatment decisions.
ISSN:2397-768X