期刊
KOREAN JOURNAL OF RADIOLOGY
卷 23, 期 1, 页码 89-100出版社
KOREAN SOCIETY OF RADIOLOGY
DOI: 10.3348/kjr.2021.0323
关键词
Alzheimer's disease; Mild cognitive impairment; Biomarker; ATN; Radiomics; Prediction
资金
- Chongqing Science and Health Joint Medical Research Project of China [2018ZDXM005]
- Chongqing Natural Science Foundation [cstc2020jcyj-msxmX0044]
- Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University [2020-7]
This study improved the N biomarker in individuals with mild cognitive impairment (MCI) using radiomics, and demonstrated its value in predicting cognitive progression. Additionally, the study clarified the predictive value of single A/T/N biomarkers for MCI cognitive progression.
Objective: To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods: A group of 147 healthy controls (HCs) (72 male; mean age +/- standard deviation, 73.7 +/- 6.3 years), 197 patients with MCI (114 male; 72.2 +/- 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 +/- 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF A beta 42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion: We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.
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