A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study

Abstract Objectives To develop and validate a deep learning radiopathomics model (DLRPM) integrating radiological and pathological imaging data to predict biliary cyclooxygenase-2 (COX-2) expression in children with pancreaticobiliary maljunction (PBM), and to compare its performance with single-mod...

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Main Authors: Hui-min Mao, Jian-jun Zhang, Bin Zhu, Wan-liang Guo
Format: Article
Language:English
Published: SpringerOpen 2025-03-01
Series:Insights into Imaging
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Online Access:https://doi.org/10.1186/s13244-025-01951-5
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author Hui-min Mao
Jian-jun Zhang
Bin Zhu
Wan-liang Guo
author_facet Hui-min Mao
Jian-jun Zhang
Bin Zhu
Wan-liang Guo
author_sort Hui-min Mao
collection DOAJ
description Abstract Objectives To develop and validate a deep learning radiopathomics model (DLRPM) integrating radiological and pathological imaging data to predict biliary cyclooxygenase-2 (COX-2) expression in children with pancreaticobiliary maljunction (PBM), and to compare its performance with single-modality radiomics, deep learning radiomics (DLR), and pathomics models. Methods This retrospective study included 219 PBM patients, divided into a training set (n = 104; median age, 2.8 years, 75.0% females) and internal test set (n = 71; median age, 2.2 years, 83.1% females) from center I, and an external test set (n = 44; median age, 3.4 years, 65.9% females) from center II. Biliary COX-2 expression was detected using immunohistochemistry. Radiomics, DLR, and pathomics features were extracted from portal venous-phase CT images and H&E-stained histopathological slides, respectively, to build individual single-modality models. These were then integrated to develop the DLRPM, combining three predictive signatures. Model performance was evaluated using AUC, net reclassification index (NRI, for assessing improvement in correct classification) and integrated discrimination improvement (IDI). Results The DLRPM demonstrated the highest performance, with AUCs of 0.851 (95% CI, 0.759–0.942) in internal test set and 0.841 (95% CI, 0.721–0.960) in external test set. In comparison, AUCs for the radiomics, DLR, and pathomics models were 0.532–0.602, 0.658–0.660, and 0.787–0.805, respectively. The DLRPM significantly outperformed three single-modality models, as demonstrated by the NRI and IDI tests (all p < 0.05). Conclusion The multimodal DLRPM could accurately and robustly predict COX-2 expression, facilitating risk stratification and personalized postoperative management in PBM. However, prospective multicenter studies with larger cohorts are needed to further validate its generalizability. Critical relevance statement Our proposed deep learning radiopathomics model, integrating CT and histopathological images, provides a novel and cost-effective approach to accurately predict biliary cyclooxygenase-2 expression, potentially advancing individualized risk stratification and improving long-term outcomes for pediatric patients with pancreaticobiliary maljunction. Key Points Predicting biliary COX-2 expression in pancreaticobiliary maljunction (PBM) is critical but challenging. A deep learning radiopathomics model achieved high predictive accuracy for COX-2. The model supports patient stratification and personalized postoperative management in PBM. Graphical Abstract
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spelling doaj-art-86cac31460e9412cb1d83f9323f0c8df2025-08-20T03:40:45ZengSpringerOpenInsights into Imaging1869-41012025-03-0116111310.1186/s13244-025-01951-5A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter studyHui-min Mao0Jian-jun Zhang1Bin Zhu2Wan-liang Guo3Department of Radiology, Children’s Hospital of Soochow UniversityDepartment of Neonatal Surgery, Xuzhou Children’s HospitalDepartment of Interventional Therapy, Xuzhou Children’s HospitalDepartment of Radiology, Children’s Hospital of Soochow UniversityAbstract Objectives To develop and validate a deep learning radiopathomics model (DLRPM) integrating radiological and pathological imaging data to predict biliary cyclooxygenase-2 (COX-2) expression in children with pancreaticobiliary maljunction (PBM), and to compare its performance with single-modality radiomics, deep learning radiomics (DLR), and pathomics models. Methods This retrospective study included 219 PBM patients, divided into a training set (n = 104; median age, 2.8 years, 75.0% females) and internal test set (n = 71; median age, 2.2 years, 83.1% females) from center I, and an external test set (n = 44; median age, 3.4 years, 65.9% females) from center II. Biliary COX-2 expression was detected using immunohistochemistry. Radiomics, DLR, and pathomics features were extracted from portal venous-phase CT images and H&E-stained histopathological slides, respectively, to build individual single-modality models. These were then integrated to develop the DLRPM, combining three predictive signatures. Model performance was evaluated using AUC, net reclassification index (NRI, for assessing improvement in correct classification) and integrated discrimination improvement (IDI). Results The DLRPM demonstrated the highest performance, with AUCs of 0.851 (95% CI, 0.759–0.942) in internal test set and 0.841 (95% CI, 0.721–0.960) in external test set. In comparison, AUCs for the radiomics, DLR, and pathomics models were 0.532–0.602, 0.658–0.660, and 0.787–0.805, respectively. The DLRPM significantly outperformed three single-modality models, as demonstrated by the NRI and IDI tests (all p < 0.05). Conclusion The multimodal DLRPM could accurately and robustly predict COX-2 expression, facilitating risk stratification and personalized postoperative management in PBM. However, prospective multicenter studies with larger cohorts are needed to further validate its generalizability. Critical relevance statement Our proposed deep learning radiopathomics model, integrating CT and histopathological images, provides a novel and cost-effective approach to accurately predict biliary cyclooxygenase-2 expression, potentially advancing individualized risk stratification and improving long-term outcomes for pediatric patients with pancreaticobiliary maljunction. Key Points Predicting biliary COX-2 expression in pancreaticobiliary maljunction (PBM) is critical but challenging. A deep learning radiopathomics model achieved high predictive accuracy for COX-2. The model supports patient stratification and personalized postoperative management in PBM. Graphical Abstracthttps://doi.org/10.1186/s13244-025-01951-5RadiomicsDeep learningPathomicsCyclooxygenase-2Pancreaticobiliary maljunction
spellingShingle Hui-min Mao
Jian-jun Zhang
Bin Zhu
Wan-liang Guo
A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study
Insights into Imaging
Radiomics
Deep learning
Pathomics
Cyclooxygenase-2
Pancreaticobiliary maljunction
title A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study
title_full A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study
title_fullStr A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study
title_full_unstemmed A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study
title_short A novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase-2 expression in common bile duct in children with pancreaticobiliary maljunction: a multicenter study
title_sort novel deep learning radiopathomics model for predicting carcinogenesis promotor cyclooxygenase 2 expression in common bile duct in children with pancreaticobiliary maljunction a multicenter study
topic Radiomics
Deep learning
Pathomics
Cyclooxygenase-2
Pancreaticobiliary maljunction
url https://doi.org/10.1186/s13244-025-01951-5
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