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<p>Pituitary neuroendocrine tumor (PitNET) aggressiveness critically affects treatment and prognosis, yet reliable noninvasive preoperative tools remain lacking. We developed a deep learning radiomics (DLR) model integrating automatic segmentation, feature extraction, selection, and DLR score computation, trained on the training cohort and validated on the remaining cohorts (total n = 1089 from three medical centers). Using nnUnet and a fine-tuned Swin Transformer, 13 key features were identified to construct the model. The DLR score demonstrated strong correlation with Knosp and Hardy-Wilson invasion classifications, while outperforming them in predicting recurrence and indicating aggressive pathological markers (Ki-67, p53, macrophages) and revealing biological pathways (MAPK, TGF-β). The model was further implemented into an online platform, enabling clinical deployment. This noninvasive preoperative approach provides a robust imaging biomarker for identifying and evaluating PitNET aggressiveness and may support individualized treatment strategies.</p>

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An MRI radiomics approach using invasion-based weak supervision for identifying and evaluating aggressive PitNETs

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月2日

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  • Yangyang Wang,
  • Xiudong Guan,
  • Shunchang Ma,
  • Yuyan Zhang,
  • Jun Yang,
  • Yan Liu,
  • Yueqian Sun,
  • Li Ma,
  • Deling Li,
  • Yongqiang Tang,
  • Chuanbao Zhang,
  • Wang Jia

摘要

Pituitary neuroendocrine tumor (PitNET) aggressiveness critically affects treatment and prognosis, yet reliable noninvasive preoperative tools remain lacking. We developed a deep learning radiomics (DLR) model integrating automatic segmentation, feature extraction, selection, and DLR score computation, trained on the training cohort and validated on the remaining cohorts (total n = 1089 from three medical centers). Using nnUnet and a fine-tuned Swin Transformer, 13 key features were identified to construct the model. The DLR score demonstrated strong correlation with Knosp and Hardy-Wilson invasion classifications, while outperforming them in predicting recurrence and indicating aggressive pathological markers (Ki-67, p53, macrophages) and revealing biological pathways (MAPK, TGF-β). The model was further implemented into an online platform, enabling clinical deployment. This noninvasive preoperative approach provides a robust imaging biomarker for identifying and evaluating PitNET aggressiveness and may support individualized treatment strategies.