Predicting symptomatic mesenteric mass in small intestinal neuroendocrine tumors using radiomics

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Abstract

Metastatic mesenteric masses of small intestinal neuroendocrine tumors (SI-NETs) are known to often cause intestinal complications. The aim of this study was to identify patients at risk to develop these complications based on routinely acquired CT scans using a standardized set of clinical criteria and radiomics. Retrospectively, CT scans of SI-NET patients with a mesenteric mass were included and systematically evaluated by five clinicians. For the radiomics approach, 1128 features were extracted from segmentations of the mesenteric mass and mesentery, after which radiomics models were created using a combination of machine learning approaches. The performances were compared to a multidisciplinary tumor board (MTB). The dataset included 68 patients (32 asymptomatic, 36 symptomatic). The clinicians had AUCs between 0.62 and 0.85 and showed poor agreement. The best radiomics model had a mean AUC of 0.77. The MTB had a sensitivity of 0.64 and specificity of 0.68. We conclude that systematic clinical evaluation of SI-NETs to predict intestinal complications had a similar performance than an expert MTB, but poor inter-observer agreement. Radiomics showed a similar performance and is objective, and thus is a promising tool to correctly identify these patients. However, further validation is needed before the transition to clinical practice.

Original languageEnglish
Pages (from-to)529-539
Number of pages11
JournalEndocrine-Related Cancer
Volume28
Issue number8
DOIs
Publication statusPublished - Aug 2021

Bibliographical note

Funding Information:
Wiro Niessen is founder, scientific lead and stock holder of ?uantib BV. Tessa Brabander is a member of the joined advisory board of AAA/ Novartis, and is a speaker and has received travel fees from AAA/Novartis and Prime Oncology. Wouter de Herder received research support from 阀psen and AAA/Novartis and received speaker fees from AAA/Novartis, Pfizer and 阀psen. The other authors do not declare any conflicts of interest.

Funding Information:
Martijn Starmans acknowledges funding from the research program STRaTeGy (project number 14929?14930), which is (partly) financed by the Netherlands Organisation for Scientific Research (NWO). Anela Blazevic received funding from the 阀psen Fund via an unrestricted research fund. This work was carried out on the Dutch national e?infrastructure with the support of SURF Cooperative.

Publisher Copyright:
© 2021 BioScientifica Ltd.. All rights reserved.

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