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基于T2加权成像及弥散加权成像的图像纹理分析预测宫颈鳞状细胞癌放化疗疗效的临床价值

苏佰燕 戚亚菲 管慧 何泳蓝 薛华丹 金征宇

苏佰燕, 戚亚菲, 管慧, 何泳蓝, 薛华丹, 金征宇. 基于T2加权成像及弥散加权成像的图像纹理分析预测宫颈鳞状细胞癌放化疗疗效的临床价值[J]. 协和医学杂志, 2021, 12(5): 713-720. doi: 10.12290/xhyxzz.2021-0380
引用本文: 苏佰燕, 戚亚菲, 管慧, 何泳蓝, 薛华丹, 金征宇. 基于T2加权成像及弥散加权成像的图像纹理分析预测宫颈鳞状细胞癌放化疗疗效的临床价值[J]. 协和医学杂志, 2021, 12(5): 713-720. doi: 10.12290/xhyxzz.2021-0380
SU Baiyan, QI Yafei, GUAN Hui, HE Yonglan, XUE Huadan, JIN Zhengyu. Texture Analysis of Sequential Images of T2-weighted Imaging and Diffusion-weighted Imaging for Predicting the Efficacy of Chemoradiotherapy in Cervical Squamous Cell Carcinoma[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(5): 713-720. doi: 10.12290/xhyxzz.2021-0380
Citation: SU Baiyan, QI Yafei, GUAN Hui, HE Yonglan, XUE Huadan, JIN Zhengyu. Texture Analysis of Sequential Images of T2-weighted Imaging and Diffusion-weighted Imaging for Predicting the Efficacy of Chemoradiotherapy in Cervical Squamous Cell Carcinoma[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(5): 713-720. doi: 10.12290/xhyxzz.2021-0380

基于T2加权成像及弥散加权成像的图像纹理分析预测宫颈鳞状细胞癌放化疗疗效的临床价值

doi: 10.12290/xhyxzz.2021-0380
基金项目: 

中国医学科学院中央级公益性科研院所基本科研业务费专项资金 2020-RW320-005

详细信息
    通讯作者:

    何泳蓝  电话:010-69159610,E-mail:heyonglan@pumch.cn

  • 中图分类号: R445; R737.33

Texture Analysis of Sequential Images of T2-weighted Imaging and Diffusion-weighted Imaging for Predicting the Efficacy of Chemoradiotherapy in Cervical Squamous Cell Carcinoma

Funds: 

Basic Research Operating Expenses of the Central Public Welfare Scientific Research Institute of Chinese Academy of Medical Sciences 2020-RW320-005

More Information
  • 摘要:   目的  探讨MRI检查T2加权成像(T2-weighted imaging, T2WI)及弥散加权成像(diffusion-weighted imaging, DWI)图像纹理参数与宫颈鳞状细胞癌放化疗疗效的相关性。  方法  回顾性纳入2015年2月至2016年1月北京协和医院接受放化疗的宫颈鳞状细胞癌患者,并根据其预后分为疾病进展组和疾病稳定组。采用TexRAD软件对两组患者放化疗前T2WI、DWI序列图像进行纹理分析,得到空间尺度滤波器(spatial scale filter,SSF)半径值为2、4、6的图像纹理参数。比较两组患者图像纹理参数差异,采用多因素Cox回归分析图像纹理参数与宫颈鳞状细胞癌患者放化疗疗效的相关性。采用受试者工作特征(receiver operating characteristic, ROC)曲线分析各图像纹理参数预测宫颈鳞状细胞癌放化疗后疾病进展的性能。  结果  共121例符合纳入和排除标准的宫颈鳞状细胞癌患者入选本研究。其中疾病进展组46例,疾病稳定组75例。T2WI序列图像中,疾病进展组与疾病稳定组患者的图像纹理参数均值(SSF2、SSF4、SSF6)、偏度(SSF2、SSF4)、熵(SSF4、SSF6)均有显著性差异(P均<0.05);DWI序列图像中,疾病进展组与疾病稳定组患者的图像纹理参数均值(SSF2、SSF4、SSF6)、偏度(SSF4、SSF6)、峰度(SSF2、SSF4)均有显著性差异(P均<0.05)。多因素Cox回归分析结果显示,T2WI序列图像纹理参数均值(SSF2、SSF4、SSF6)及DWI序列图像纹理参数均值(SSF2、SSF6)、熵(SSF2、SSF4、SSF6)、偏度(SSF4、SSF6)与宫颈鳞状细胞癌放化疗疗效具有相关性(P<0.05)。ROC曲线分析结果显示,图像纹理参数均值(T2WI-SSF2、T2WI-SSF4、T2WI-SSF6、DWI-SSF2、DWI-SSF6)、偏度(DWI-SSF6)可预测宫颈鳞状细胞癌放化疗后的疾病进展,曲线下面积(area under the curve, AUC)为0.625~0.746。其中,均值(T2WI-SSF4)的预测效能最高(AUC:0.746),其次为均值(T2WI-SSF2,AUC:0.725)、均值(T2WI-SSF6,AUC:0.703)。  结论  基线MRI检查T2WI、DWI图像纹理参数与宫颈鳞状细胞癌放化疗疗效具有相关性,其均值、偏度可预测宫颈鳞状细胞癌放化疗后疾病进展,且以均值的预测效能最高。
    作者贡献:苏佰燕负责研究设计、数据分析、结果解读及论文撰写;戚亚菲、管慧参与研究设计、数据采集;何泳蓝、薛华丹、金征宇参与数据分析、研究实施、结果解读并指导论文修改。
    利益冲突:
  • 图  1  MRI检查DWI序列图像纹理分析示意图

    A.病灶ROI内的DWI图像及SSF 2、4、6图像纹理参数示意图;B.SSF 0、2、3、4、5、6图像纹理参数分析结果示意图
    DWI:弥散加权成像;ROI:感兴趣区;SSF:空间尺度滤波器

    图  2  图像纹理参数预测宫颈鳞癌放化疗后疾病进展的ROC曲线图

    T2WI:同表 1;DWI、SSF:同图 1;ROC:受试者工作特征

    表  1  疾病进展组与疾病稳定组T2WI序列图像纹理参数比较

    纹理参数 疾病进展组(n=46) 疾病稳定组(n=75) P
    SSF2
        均值 -10.49±39.80 23.18±44.64 0.000
        标准差 196.55±146.14 176.52±79.19 0.330
        熵 6.21±0.38 6.09±0.38 0.083
        正性像素均值 136.49±111.75 141.71±67.66 0.749
        偏度 -0.20±1.14 0.36±0.98 0.006
        峰度 3.56±5.68 3.47±4.63 0.921
    SSF4
        均值 -77.20±114.50 15.93±87.27 0.000
        标准差 274.70±209.93 228.59±115.02 0.121
        熵 6.42±0.43 6.23±0.44 0.019
        正性像素均值 158.35±131.36 179.13±134.13 0.406
        偏度 -0.66±0.77 -0.21±0.91 0.007
        峰度 1.94±1.93 1.95±2.29 0.990
    SSF6
        均值 -173.73±220.73 -38.99±138.36 0.000
        标准差 357.91±295.41 280.95±144.38 0.058
        熵 6.61±0.47 6.37±0.50 0.008
        正性像素均值 193.85±189.00 190.23±152.54 0.908
        偏度 -0.58±0.65 -0.49±0.80 0.511
        峰度 0.75±1.09 1.09±2.04 0.233
    T2WI:T2加权成像;SSF:同图 1
    下载: 导出CSV

    表  2  疾病进展组与疾病稳定组DWI序列图像纹理参数比较

    纹理参数 疾病进展组(n=46) 疾病稳定组(n=75) P
    SSF2
        均值 90.23±70.23 137.98±92.76 0.003
        标准差 177.82±99.68 184.03±73.59 0.715
        熵 5.42±0.67 5.35±0.52 0.544
        正性像素均值 178.08±100.63 208.95±98.85 0.100
        偏度 0.26±0.52 0.22±0.41 0.601
        峰度 0.96±2.02 0.32±0.79 0.047
    SSF4
        均值 259.14±188.83 356.65±210.77 0.011
        标准差 277.17±163.90 265.50±110.31 0.671
        熵 5.58±0.67 5.46±0.56 0.265
        正性像素均值 344.81±207.11 412.02±205.43 0.084
        偏度 0.23±0.62 0.03±0.48 0.047
        峰度 0.50±1.51 -0.01±0.70 0.036
    SSF6
        均值 428.56±288.62 544.30±273.42 0.029
        标准差 302.58±179.16 290.13±115.29 0.675
        熵 5.61±0.69 5.48±0.57 0.262
        正性像素均值 487.95±293.02 576.29±265.70 0.090
        偏度 0.12±0.49 -0.09±0.34 0.012
        峰度 -0.08±0.88 -0.32±0.57 0.104
    DWI、SSF:同图 1
    下载: 导出CSV

    表  3  图像纹理参数与宫颈鳞癌放化疗后疾病进展相关性的Cox回归分析阳性结果

    纹理参数 HR(95% CI) P
    T2WI-SSF2-均值 0.984(0.968~1.000) 0.045
    T2WI-SSF4-均值 0.996(0.991~1.000) 0.044
    T2WI-SSF6-均值 0.996(0.993~0.999) 0.019
    DWI-SSF2-均值 0.959(0.935~0.983) 0.001
    DWI-SSF2-熵 0.327(0.163~0.654) 0.002
    DWI-SSF4-熵 0.462(0.257~0.831) 0.010
    DWI-SSF4-偏度 1.897(1.019~3.531) 0.043
    DWI-SSF6-均值 0.988(0.978~0.999) 0.033
    DWI-SSF6-熵 0.488(0.275~0.867) 0.014
    DWI-SSF6-偏度 3.882(1.755~8.587) 0.001
    T2WI:同表 1;DWI、SSF:同图 1
    下载: 导出CSV
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  • 收稿日期:  2021-05-10
  • 录用日期:  2021-07-30
  • 刊出日期:  2021-09-30

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