Radiomics nomogram for the prediction of Ki-67 index in advanced non-small cell lung cancer based on dual-phase enhanced computed tomography.

purposeTo develop a radiomics nomogram based on dual-phase enhanced computed tomography (CT) for predicting the Ki-67 index status in patients with advanced non-small cell lung cancer (NSCLC).

methods137 patients with NSCLC who had undergone dual-phase enhanced CT scans and Ki-67 examination within 2 weeks were retrospectively enrolled between January 2020 and December 2022. Clinical and laboratory data were collected, and the patients were categorized based on low or high expression of Ki-67 index, with a cut-off value of 40%. The cohort was randomly divided into a training group (n = 95) and a testing group (n = 42) at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) algorithm was employed to select the most valuable radiomics features from the dual-phase enhanced CT images. Subsequently, a nomogram that incorporated the radiomics score and clinical factors associated with Ki-67 index status was established through univariate and multivariate logistic regression analyses. The predictive performance of the nomogram was evaluated using the area under the curve (AUC).

resultsThe AUC values of the radiomics features of artery phase and vein phase CT in the testing group were 0.748 and 0.758, respectively. The AUC of the dual-phase enhanced CT was 0.785, and the AUC of the developed nomogram was 0.859, which was higher than those of the radiomics (AUC, 0.785) and clinical models (AUC, 0.736).

conclusionsThe radiomics nomogram based on dual-phase enhanced CT images provides a promising method for predicting the Ki-67 index status in patients with advanced NSCLC.