Compute Tomography Radiomics Analysis on Whole Pancreas Between Healthy Individual and Pancreatic Ductal Adenocarcinoma Patients: Uncertainty Analysis and Predictive Modeling

Radiomics is a rapidly growing field that quantitatively extracts image features in a high-throughput manner from medical imaging. In this study, we analyzed the radiomics features of the whole pancreas between healthy individuals and pancreatic cancer patients, and we established a predictive model that can distinguish cancer patients from healthy individuals based on these radiomics features. Methods: We retrospectively collected venous-phase scans of contrast-enhanced computed tomography (CT) images from 181 control subjects and 85 cancer case subjects for radiomics analysis and predictive modeling. An attending radiation oncologist delineated the pancreas for all the subjects in the Varian Eclipse system, and we extracted 924 radiomics features using PyRadiomics. We established a feature selection pipeline to exclude redundant or unstable features. We randomly selected 189 cases (60 cancer and 129 control) as the training set. The remaining 77 subjects (25 cancer and 52 control) as a test set. We trained a Random Forest model utilizing the stable features to distinguish the cancer patients from the healthy individuals on the training dataset. We analyzed the performance of our best model by running 5-fold cross-validations on the training dataset and applied our best model to the test set. Results: We identified that 91 radiomics features are stable against various uncertainty sources, including bin width, resampling, image transformation, image noise, and segmentation uncertainty. Eight of the 91 features are nonredundant. Our final predictive model, using these 8 features, has achieved a mean area under the receiver operating characteristic curve (AUC) of 0.99 ± 0.01 on the training dataset (189 subjects) by cross-validation. The model achieved an AUC of 0.910 on the independent test set (77 subjects) and an accuracy of 0.935. Conclusion: CT-based radiomics analysis based on the whole pancreas can distinguish cancer patients from healthy individuals, and it could potentially become an early detection tool for pancreatic cancer.