Discussion
lung cancer
LUNG CANCER
In this study, we successfully explored a CBR nomogram incorporating multi-scale features, which held a more excellent performance in non-invasively N staging for lung cancer patients with hypermetabolic mediastinal–hilar LNs than conventional PET/CT, thereby greatly reducing the risk of overestimation and assisting for precision treatment.Growing evidence suggests that radiomics integrated general CBI features achieve higher diagnostic efficacy than using them alone [Accurately identifying FP LNs is more challenging than assessing all LNs in lung cancer. To the best of our knowledge, only Ouyang et alThe accuracy of histologic staging of hypermetabolic LNs is also related to the clinico-biological-image factors. Patients’ age has been proven to be an independent risk factor, which means younger patients were more prone to having LNM, consistent with the positive status of pretherapeutic serum CEA [Furthermore, we generated an integrated nomogram on the basis of the CBR Model for facilitating its use in clinical practice. Then, the physicians could perform a preoperative individualized prediction of the LNM risk with this easy-to-use scoring tool, which could provide a non-invasive and accurate approach for patients who were unwilling or unable to undergo biopsy to develop more reasonable and effective treatment plans. The DCA also showed the nomogram added more benefit than either the treat-all-patients as LN− or the treat-all-patients as LN + , which was more valuable for the current trend toward personalized medicine [This study still has some limitations. Firstly, this retrospective study was conducted in a single center, which was the main cause of the decrease in RQS and also led to patient selection bias. It is necessary to design another prospective, multi-center, and large-cohort study to further validate the performance and generalization ability of the CBR Model in the real-world clinical settings [In conclusion, an integrated CBR nomogram was successfully developed and validated in our study, which could further reduce the FPR and improve the accuracy of hypermetabolic mediastinal–hilar LNs evaluation in lung cancer than conventional PET/CT, thereby greatly reducing the risk of overestimation and assisting for precision treatment.