Development and validation of a radiomics signature for clinically significant portal hypertension in cirrhosis (CHESS1701): a prospective multicenter studyResearch in context
Fuquan Liu,
Zhenyuan Ning,
Yanna Liu,
Dengxiang Liu,
Jie Tian,
Hongwu Luo,
Weimin An,
Yifei Huang,
Jialiang Zou,
Chuan Liu,
Changchun Liu,
Lei Wang,
Zaiyi Liu,
Ruizhao Qi,
Changzeng Zuo,
Qingge Zhang,
Jitao Wang,
Dawei Zhao,
Yongli Duan,
Baogang Peng,
Xingshun Qi,
Yuening Zhang,
Yongping Yang,
Jinlin Hou,
Jiahong Dong,
Zhiwei Li,
Huiguo Ding,
Yu Zhang,
Xiaolong Qi
Affiliations
Fuquan Liu
CHESS Group, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Zhenyuan Ning
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; School of Biomedical Engineering, Southern Medical University, Guangzhou, China
Yanna Liu
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
Dengxiang Liu
Xingtai People's Hospital, Xingtai Institute of Cancer Control, Xingtai, China
Jie Tian
Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China
Hongwu Luo
Department of General Surgery, The Third Xiangya Hospital of Central South University, Changsha, China
Weimin An
Department of Radiology, 302 Hospital of PLA, Beijing, China
Yifei Huang
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
Jialiang Zou
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
Chuan Liu
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
Changchun Liu
Department of Radiology, 302 Hospital of PLA, Beijing, China
Lei Wang
CHESS Group, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Zaiyi Liu
Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
Ruizhao Qi
Department of General Surgery, 302 Hospital of PLA, Beijing, China
Changzeng Zuo
Xingtai People's Hospital, Xingtai Institute of Cancer Control, Xingtai, China
Qingge Zhang
Xingtai People's Hospital, Xingtai Institute of Cancer Control, Xingtai, China
Jitao Wang
Xingtai People's Hospital, Xingtai Institute of Cancer Control, Xingtai, China
Dawei Zhao
Department of Radiology, Beijing You'an Hospital, Capital Medical University, Beijing, China
Yongli Duan
Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Baogang Peng
Department of Hepatobiliary Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Xingshun Qi
Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China
Yuening Zhang
Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing, China
Yongping Yang
Center for Therapeutic Research of Hepatocarcinoma, 302 Hospital of PLA, Beijing, China
Jinlin Hou
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China
Jiahong Dong
Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
Zhiwei Li
Department of General Surgery, 302 Hospital of PLA, Beijing, China; Department of Hepatobiliary Surgery, The Third People's Hospital of Shenzhen, Shenzhen, China
Huiguo Ding
Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing, China; Correspondence to: H. Ding, Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Yu Zhang
School of Biomedical Engineering, Southern Medical University, Guangzhou, China; Correspondence to: Y. Zhang, School of Biomedical Engineering, Southern Medical University, Guangzhou, China.
Xiaolong Qi
CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; CHESS Frontier Center, Lanzhou University, Lanzhou, China; Correspondence to: X. Qi, CHESS Group, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China.
Clinically significant portal hypertension (CSPH) is associated with an incremental risk of esophageal varices and overt clinical decompensations. However, hepatic venous pressure gradient (HVPG) measurement, the gold standard for defining CSPH (HVPG≥10 mm Hg) is invasive and therefore not suitable for routine clinical practice. This study aims to develop and validate a radiomics-based model as a noninvasive method for accurate detection of CSPH in cirrhosis.The prospective multicenter diagnostic trial (CHESS1701, ClinicalTrials.gov identifier: NCT03138915) involved 385 patients with cirrhosis from five liver centers in China between August 2016 and September 2017. Patients who had both HVPG measurement and contrast-enhanced CT within 14 days prior to the catheterization were collected. The noninvasive radiomics model, termed rHVPG for CSPH was developed based on CT images in a training cohort consisted of 222 consecutive patients and the diagnostic performance was prospectively assessed in 163 consecutive patients in four external validation cohorts.rHVPG showed a good performance in detection of CSPH with a C-index of 0·849 (95%CI: 0·786–0·911). Application of rHVPG in four external prospective validation cohorts still gave excellent performance with the C-index of 0·889 (95%CI: 0·752–1·000, 0·800 (95%CI: 0·614–0·986), 0·917 (95%CI: 0·772–1·000), and 0·827 (95%CI: 0·618–1·000), respectively. Intraclass correlation coefficients for inter- and intra-observer agreement were 0·92–0·99 and 0·97–0·99, respectively.A radiomics signature was developed and prospectively validated as an accurate method for noninvasive detection of CSPH in cirrhosis. The tool of rHVPG assessment can facilitate the identification of CSPH rapidly when invasive transjugular procedure is not available. Keywords: Portal hypertension, Liver cirrhosis, Hepatic venous pressure gradient, Radiomics, Noninvasive
