TY - JOUR
T1 - An evidential reasoning based model for diagnosis of lymph node metastasis in gastric cancer
AU - Zhou, Zhi Guo
AU - Liu, Fang
AU - Jiao, Li Cheng
AU - Wang, Zhi Long
AU - Zhang, Xiao Peng
AU - Wang, Xiao Dong
AU - Luo, Xiao Zhuo
N1 - Funding Information:
The authors thank the editor and two referees for their constructive comments and suggestions, which have been very help in enhancing the paper quality. The authors would like to thank Pro. M Emmerich and Dr. Yuwang Chen to give a great help to this work. This research was supported in part by the Fund for Foreign Scholars in University Research and Teaching Programs(the 111 Project)(Grant No. B07048), in part by the National Natural Science Foundation of China(No. 60970067, No. 61072139, No. 61272282, No. 61173092), in part by the Program for Cheung Kong Scholars and Innovative Research Team in University(No. IRT1170), and in part by the Fundamental Research Funds for the Central Universities (No. K5051203002).
PY - 2013
Y1 - 2013
N2 - Background: Lymph node metastasis (LNM) in gastric cancer is a very important prognostic factor affecting long-term survival. Currently, several common imaging techniques are used to evaluate the lymph node status. However, they are incapable of achieving both high sensitivity and specificity simultaneously. In order to deal with this complex issue, a new evidential reasoning (ER) based model is proposed to support diagnosis of LNM in gastric cancer. Methods. There are 175 consecutive patients who went through multidetector computed tomography (MDCT) consecutively before the surgery. Eight indicators, which are serosal invasion, tumor classification, tumor enhancement pattern, tumor thickness, number of lymph nodes, maximum lymph node size, lymph node station and lymph node enhancement are utilized to evaluate the tumor and lymph node through CT images. All of the above indicators reflect the biological behavior of gastric cancer. An ER based model is constructed by taking the above indicators as input index. The output index determines whether LNM occurs for the patients, which is decided by the surgery and histopathology. A technique called k-fold cross-validation is used for training and testing the new model. The diagnostic capability of LNM is evaluated by receiver operating characteristic (ROC) curves. A Radiologist classifies LNM by adopting lymph node size for comparison. Results: 134 out of 175 cases are cases of LNM, and the remains are not. Eight indicators have statistically significant difference between the positive and negative groups. The sensitivity, specificity and AUC of the ER based model are 88.41%, 77.57% and 0.813, respectively. However, for the radiologist evaluating LNM by maximum lymph node size, the corresponding values are only 63.4%, 75.6% and 0.757. Therefore, the proposed model can obtain better performance than the radiologist. Besides, the proposed model also outperforms other machine learning methods. Conclusions: According to the biological behavior information of gastric cancer, the ER based model can diagnose LNM effectively and preoperatively.
AB - Background: Lymph node metastasis (LNM) in gastric cancer is a very important prognostic factor affecting long-term survival. Currently, several common imaging techniques are used to evaluate the lymph node status. However, they are incapable of achieving both high sensitivity and specificity simultaneously. In order to deal with this complex issue, a new evidential reasoning (ER) based model is proposed to support diagnosis of LNM in gastric cancer. Methods. There are 175 consecutive patients who went through multidetector computed tomography (MDCT) consecutively before the surgery. Eight indicators, which are serosal invasion, tumor classification, tumor enhancement pattern, tumor thickness, number of lymph nodes, maximum lymph node size, lymph node station and lymph node enhancement are utilized to evaluate the tumor and lymph node through CT images. All of the above indicators reflect the biological behavior of gastric cancer. An ER based model is constructed by taking the above indicators as input index. The output index determines whether LNM occurs for the patients, which is decided by the surgery and histopathology. A technique called k-fold cross-validation is used for training and testing the new model. The diagnostic capability of LNM is evaluated by receiver operating characteristic (ROC) curves. A Radiologist classifies LNM by adopting lymph node size for comparison. Results: 134 out of 175 cases are cases of LNM, and the remains are not. Eight indicators have statistically significant difference between the positive and negative groups. The sensitivity, specificity and AUC of the ER based model are 88.41%, 77.57% and 0.813, respectively. However, for the radiologist evaluating LNM by maximum lymph node size, the corresponding values are only 63.4%, 75.6% and 0.757. Therefore, the proposed model can obtain better performance than the radiologist. Besides, the proposed model also outperforms other machine learning methods. Conclusions: According to the biological behavior information of gastric cancer, the ER based model can diagnose LNM effectively and preoperatively.
KW - Evidential reasoning
KW - Gastric cancer
KW - Lymph node metastasis
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U2 - 10.1186/1472-6947-13-123
DO - 10.1186/1472-6947-13-123
M3 - Article
C2 - 24195733
AN - SCOPUS:84887050780
SN - 1472-6947
VL - 13
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 123
ER -