Application of computed tomography-based radiomics in differential diagnosis of adenocarcinoma and squamous cell carcinoma at the esophagogastric junction

Figure 1 A 43-year-old man with squamous cell carcinoma of the esophagogastric junction. A: Axial computed tomography image in venous phase; B: Schematic diagram of 2D region of interest (ROI) segmentation on ITK-SNAP software; C: Schematic diagram of 3D ROI segmentation on ITK-SNAP software; D: Postoperative pathological image confirming squamous cell carcinoma of the esophagogastric junction (HE staining, × 200).

Figure 2 A 56-year-old man with adenocarcinoma of the esophagogastric junction. A: Axial computed tomography image in venous phase; B: Schematic diagram of 2D region of interest (ROI) segmentation on ITK-SNAP software; C: Schematic diagram of 3D ROI segmentation on ITK-SNAP software; D: Postoperative pathological image confirming adenocarcinoma of the esophagogastric junction (HE staining, × 200).

Figure 3 Least absolute shrinkage and selection operator logistic regression feature screening graphs. The radiomics feature screening using the least absolute shrinkage and selection operator regression was performed to select the optimal model parameter λ using 10-fold cross-validation. A, C, E, and G: Graphs of binomial deviation of 2D-arterial model, 2D-venous model, 3D-arterial model, and 3D-venous model with parameter λ, respectively. The dashed lines indicate the selected optimal log(λ) values and the location of one standard error; B, D, F, and H: Graphs of variation of the radiomics characteristic coefficients with log(λ) for 2D-arterial model, 2D-venous model, 3D-arterial model, and 3D-venous model, respectively. The dotted line indicates the location of the selected optimal log(λ) value.

Figure 4 Receiver operating characteristic curves of different models to identify squamous cell carcinoma and adenocarcinoma of the esophagogastric junction. A: Training group; B: Test group.

Figure 5 Calibration curves of 2D-arterial model, 2D-venous model, 3D-arterial model, 3D-venous model, 2D arterial-venous combined model, and 3D arterial-venous combined model to identify squamous cell carcinoma of the esophagogastric junction and adenocarcinoma of the esophagogastric junction. A: Training group; B: Test group.

Figure 6 Decision curves for 2D-arterial model, 2D venous model, 3D-arterial model, 3D venous model, 2D arterial-venous combined model, and 3D arterial-venous combined model. A: Training group; B: Test group. The black horizontal line indicates no lesions as squamous cell carcinoma (NONE) and the grey line indicates all lesions as squamous cell carcinoma (ALL). The colored lines of each model respectively illustrate the net benefit brought to each patient. The closer the decision curves to the black and gray curves, the similar the clinical decision net benefit of the model compared with “treat ALL” or “treat NONE” decision. When comparing different models, the higher the model curve within the same threshold probability, the higher the clinical net benefit resulting from the model.