A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors
Abstract Objectives Post-surgical prediction of recurrence or metastasis for primary gastrointestinal stromal tumors (GISTs) remains challenging. We aim to develop individualized clinical follow-up strategies for primary GIST patients, such as shortening follow-up time or extending drug administrati...
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SpringerOpen
2025-06-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-025-02011-8 |
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| author | WenJie Xie Zhen Zhang Zhao Sun XiaoChen Wan JieHan Li JianWu Jiang Qi Liu Ge Yang Yang Fu |
| author_facet | WenJie Xie Zhen Zhang Zhao Sun XiaoChen Wan JieHan Li JianWu Jiang Qi Liu Ge Yang Yang Fu |
| author_sort | WenJie Xie |
| collection | DOAJ |
| description | Abstract Objectives Post-surgical prediction of recurrence or metastasis for primary gastrointestinal stromal tumors (GISTs) remains challenging. We aim to develop individualized clinical follow-up strategies for primary GIST patients, such as shortening follow-up time or extending drug administration based on the clinical deep learning radiomics model (CDLRM). Methods The clinical information on primary GISTs was collected from two independent centers. Postoperative recurrence or metastasis in GIST patients was defined as the endpoint of the study. A total of nine machine learning models were established based on the selected features. The performance of the models was assessed by calculating the area under the curve (AUC). The CDLRM with the best predictive performance was constructed. Decision curve analysis (DCA) and calibration curves were analyzed separately. Ultimately, our model was applied to the high-potential malignant group vs the low-malignant-potential group. The optimal clinical application scenarios of the model were further explored by comparing the DCA performance of the two subgroups. Results A total of 526 patients, 260 men and 266 women, with a mean age of 62 years, were enrolled in the study. CDLRM performed excellently with AUC values of 0.999, 0.963, and 0.995 for the training, external validation, and aggregated sets, respectively. The calibration curve indicated that CDLRM was in good agreement between predicted and observed probabilities in the validation cohort. The results of DCA’s performance in different subgroups show that it was more clinically valuable in populations with high malignant potential. Conclusion CDLRM could help the development of personalized treatment and improved follow-up of patients with a high probability of recurrence or metastasis in the future. Critical relevance statement This model utilizes imaging features extracted from CT scans (including radiomic features and deep features) and clinical data to accurately predict postoperative recurrence and metastasis in patients with primary GISTs, which has a certain auxiliary role in clinical decision-making. Key Points We developed and validated a model to predict recurrence or metastasis in patients taking oral imatinib after GIST. We demonstrate that CT image features were associated with recurrence or metastases. The model had good predictive performance and clinical benefit. Graphical Abstract |
| format | Article |
| id | doaj-art-fe63ee0135524bada3db361c7906b9c8 |
| institution | Kabale University |
| issn | 1869-4101 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj-art-fe63ee0135524bada3db361c7906b9c82025-08-20T03:31:45ZengSpringerOpenInsights into Imaging1869-41012025-06-0116111310.1186/s13244-025-02011-8A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumorsWenJie Xie0Zhen Zhang1Zhao Sun2XiaoChen Wan3JieHan Li4JianWu Jiang5Qi Liu6Ge Yang7Yang Fu8Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, Henan Cancer HospitalDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityOphthalmology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou UniversityAbstract Objectives Post-surgical prediction of recurrence or metastasis for primary gastrointestinal stromal tumors (GISTs) remains challenging. We aim to develop individualized clinical follow-up strategies for primary GIST patients, such as shortening follow-up time or extending drug administration based on the clinical deep learning radiomics model (CDLRM). Methods The clinical information on primary GISTs was collected from two independent centers. Postoperative recurrence or metastasis in GIST patients was defined as the endpoint of the study. A total of nine machine learning models were established based on the selected features. The performance of the models was assessed by calculating the area under the curve (AUC). The CDLRM with the best predictive performance was constructed. Decision curve analysis (DCA) and calibration curves were analyzed separately. Ultimately, our model was applied to the high-potential malignant group vs the low-malignant-potential group. The optimal clinical application scenarios of the model were further explored by comparing the DCA performance of the two subgroups. Results A total of 526 patients, 260 men and 266 women, with a mean age of 62 years, were enrolled in the study. CDLRM performed excellently with AUC values of 0.999, 0.963, and 0.995 for the training, external validation, and aggregated sets, respectively. The calibration curve indicated that CDLRM was in good agreement between predicted and observed probabilities in the validation cohort. The results of DCA’s performance in different subgroups show that it was more clinically valuable in populations with high malignant potential. Conclusion CDLRM could help the development of personalized treatment and improved follow-up of patients with a high probability of recurrence or metastasis in the future. Critical relevance statement This model utilizes imaging features extracted from CT scans (including radiomic features and deep features) and clinical data to accurately predict postoperative recurrence and metastasis in patients with primary GISTs, which has a certain auxiliary role in clinical decision-making. Key Points We developed and validated a model to predict recurrence or metastasis in patients taking oral imatinib after GIST. We demonstrate that CT image features were associated with recurrence or metastases. The model had good predictive performance and clinical benefit. Graphical Abstracthttps://doi.org/10.1186/s13244-025-02011-8Gastrointestinal stromal tumorsRadiomicsMachine learningDeep learningRecurrence or metastasis |
| spellingShingle | WenJie Xie Zhen Zhang Zhao Sun XiaoChen Wan JieHan Li JianWu Jiang Qi Liu Ge Yang Yang Fu A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors Insights into Imaging Gastrointestinal stromal tumors Radiomics Machine learning Deep learning Recurrence or metastasis |
| title | A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors |
| title_full | A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors |
| title_fullStr | A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors |
| title_full_unstemmed | A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors |
| title_short | A machine learning model integrating clinical-radiomics-deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors |
| title_sort | machine learning model integrating clinical radiomics deep learning features accurately predicts postoperative recurrence and metastasis of primary gastrointestinal stromal tumors |
| topic | Gastrointestinal stromal tumors Radiomics Machine learning Deep learning Recurrence or metastasis |
| url | https://doi.org/10.1186/s13244-025-02011-8 |
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