摘要
目的探讨18F-FDG PET/CT图像纹理分析对非小细胞肺癌(NSCLC)纵隔淋巴结分期及进展期NSCLC放化疗疗效的预测价值。方法回顾性分析经病理证实的86例NSCLC患者的18F-FDG PET/CT图像;淋巴结转移以病理检查为诊断的金标准,分为转移组、非转移组。其中56例行放化疗的NSCLC患者依据治疗后实体肿瘤疗效评价标准(RECIST)(Version 1.1)进行疗效评估,并分为缓解与非缓解组。测量其标准化摄取值(SUV)和图像纹理参数(平均值、标准差、偏度、峰度、均匀性、能量和熵值)。采用独立样本t检验比较淋巴结转移组与非转移组、缓解与非缓解组治疗前基线SUVmax值和图像纹理参数差异。构建ROC曲线分析各参数预测转移淋巴结和放化疗敏感性肿瘤的诊断效能。结果淋巴结转移组与非转移组比较,短径、SUVmax、峰度、能量及熵差异均具有统计学意义(P值均<0.05);以短径、SUVmax、峰度、熵及能量作为评估效应值,ROC曲线下面积分别为0.654、0.735、0.721、0.796、0.884。短径的敏感性、特异性分别为78.4%、55.1%;SUVmax的敏感性、特异性分别为72.4%、75.1%;峰度的敏感性、特异性分别为71.8%、63.7%;能量的敏感性、特异性分别为73.4%, 77.1%;熵的敏感性、特异性分别为86.8%、89.5%。56例行放化疗治疗中缓解组与非缓解组治疗前基线SUVmax值和图像纹理参数比较,SUVmax、熵、能量差异均有统计学意义(均18F<0.05);以SUVmax、熵及能量作为评估效应值,ROC曲线下面积分别为0.717、0.812、0.851;SUVmax的敏感性、特异性分别为74.4%、69.5%;能量的敏感性、特异性分别为79.4%、为82.1%;熵的敏感性、特异性分别为88.3%、80.8%。结论 18F-FDG PET/CT图像纹理分析有助于指导NSCLC纵隔淋巴结分期及预测进展期NSCLC放化疗疗效。
Objective To investigate the value of 18F-FDG PET/CT image texture analysis for assessing mediastinal lymph node and predicting the curative effect of advanced radiotherapy and chemotherapy for non-small cell lung cancer. Methods 18F-FDG PET/CT images of patients with NSCLC confirmed by pathology in our hospital from January 2016 to November 2017 were retrospectively analyzed. Lymph node metastasis was confirmed by pathological examination,and was divided into metastatic group and non-metastatic group. 56 patients who underwent chemoradiation were divided into remission and non-remission groups according to the Response Evaluation Criteria in Solid Tumors(RECIST)(Version 1.1). Standardized uptake value(SUV) and image texture parameters(including mean,standard deviation,skewness,kurtosis,homogeneity,energy,and entropy values) were measured. Independent sample t-test was used to compare baseline SUV values and image texture parameters between the lymph node metastasis group and non-metastatic group,remission and non-remission groups. ROC curve was constructed to analyze the value of these parameters in predicting metastatic lymph nodes and radiochemotherapy sensitive tumors. Results The differences of short diameter,SUVmax,kurtosis,energy and entropy between the lymph node metastasis group and the non-metastatic group were statistically significant(all P<0.05). The short diameter,SUVmax,kurtosis,entropy and energy were used as evaluation effect values. The area under the ROC curve(AUC) was 0.654,0.735,0.721,0.796,and 0.884,respectively. The sensitivity and specificity of short diameter were 78.4% and 55.1%,respectively. The sensitivity and specificity of SUVmax were 72.4% and 75.1%,respectively. The sensitivity and specificity of kurtosis were 71.8% and 63.7%,respectively. The specificity was 73.4% and 77.1%,respectively. The sensitivity and specificity of entropy were 86.8% and 89.5%,respectively. The SUVmax,entropy and energy between the remission group and the non-remission group were compared. The differences i
作者
张斌
马玉波
耿彦方
周冰
ZHANG Bin;MA Yubo;GENG Yanfang(Department of Radiology,Puyang People*s Hospital,Puyang,Henan Province 457000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第10期1852-1856,共5页
Journal of Clinical Radiology
基金
PET-CT分子影像应用示范及其支撑技术研究基金项目(编号:2017YEC0114003)
关键词
非小细胞肺癌
纹理分析
淋巴结
脱氧葡萄糖
Non-small cell lung cancer
Texture analysis
Lymph node
Deoxyglucose
