ASO Visual Abstract: Radiomics with Artificial Intelligence for the Prediction of Early Recurrence in Patients with Clinical Stage IA Lung Cancer

Background: We seek to explore the ability of computed tomography (CT)-based radiomics coupled with artificial intelligence (AI) to predict early recurrence (< 2 years after surgery) in patients with clinical stage 0–IA non-small cell lung cancer (c-stage 0–IA NSCLC). Patients and Methods: Data of 642 patients were collected for early recurrence and assigned to the derivation and validation cohorts at a ratio of 2:1. Using the AI software Beta Version (Fujifilm Corporation, Japan), 39 AI imaging factors, including 17 factors from the AI ground-glass nodule analysis and 22 radiomic features from nodule characterization analysis, were extracted. Results: Multivariate analysis showed that male sex (p = 0.016), solid part size (p < 0.001), CT value standard deviation (p = 0.038), solid part volume ratio (p = 0.016), and bronchus translucency (p = 0.007) were associated with recurrence-free survival (RFS). Receiver operating characteristics analysis showed that the area under the curve and optimal cutoff values relevant to recurrence were 0.707 and 1.49 cm for solid part size, and 0.710 and 22.9% for solid part volume ratio, respectively. The 5-year RFS rates for patients in the validation set with solid part size ≤ 1.49 cm and > 1.49 cm were 92.2% and 70.4% (p < 0.001), whereas those for patients with solid part volume ratios ≤ 22.9% and > 22.9% were 97.8% and 71.7% (p < 0.001), respectively. Conclusions: CT-based radiomics coupled with AI contributes to the noninvasive prediction of early recurrence in patients with c-stage 0–IA NSCLC. © 2022, Society of Surgical Oncology.