A Clinical-Radiomics Nomogram for Preoperative Prediction of Lymph Node Metastasis in Gallbladder Cancer.

Objectives: The aim of the current study was to develop and validate a nomogram based on CT radiomics features and clinical variables for predicting lymph node metastasis (LNM) in gallbladder cancer (GBC).

Methods: A total of 353 GBC patients from two hospitals were enrolled in this study. A Radscore was developed using least absolute shrinkage and selection operator (LASSO) logistic model based on the radiomics features extracted from the portal venous-phase computed tomography (CT). Four prediction models were constructed based on the training cohort and were validated using internal and external validation cohorts. The most effective model was then selected to build a nomogram.

Results: The clinical-radiomics nomogram, which comprised Radscore and three clinical variables, showed the best diagnostic efficiency in the training cohort (AUC = 0.851), internal validation cohort (AUC = 0.819), and external validation cohort (AUC = 0.824). Calibration curves showed good discrimination ability of the nomogram using the validation cohorts. Decision curve analysis (DCA) showed that the nomogram had a high clinical utility.

Conclusion: The findings showed that the clinical-radiomics nomogram based on radiomics features and clinical parameters is a promising tool for preoperative prediction of LN status in patients with GBC.