摘要
目的应用CT影像组学特征分析食管癌患者左心室肌在放疗前后的变化,建立影像组学特征变化与心肌受照剂量关系,为放射性心肌损伤的早期预测提供依据。方法回顾性分析2017-05-28-2021-06-28山东省肿瘤医院80例胸下段食管癌放疗患者的病例资料,分别获取首次放疗前及末次放疗结束后的CT图像。分别勾画0~10、10~20、20~30、30~40、40~50、>50 Gy剂量梯度的左心室肌为感兴趣区域,提取各感兴趣区域影像组学特征并筛选得到稳定特征,分析不同剂量梯度放疗前后影像组学特征变化。结果(1)每个剂量梯度下各提取93个影像组学特征,筛选得到87个稳定特征。(2)在放疗前后不同剂量梯度下差异有统计学意义的特征共8个(Z=-2,445~-1.964,P=0.019~0.049),其中20~30 Gy下特征数量最多,为6个,GLCM ClusterShade变化率最大(1138.67%)。(3)10~20、20~30、30~40、40~50 Gy梯度下仅有1个共性特征GLSZM ZoneEntropy,变化率分别为2.87%、2.32%、2.61%和5.19%,其变化随剂量增加呈先下降后上升趋势,整体呈上升趋势。结论CT影像组学特征可揭示食管癌患者左心室肌在放疗前后不同剂量梯度下的微观变化,为放射性心肌损伤的早期预测提供参考。20~30 Gy影像组学特征变化最为显著,在食管癌放疗计划设计时必须控制此剂量范围。
Objective To analyse the changes in left ventricular myocardial in patients with esophageal cancer before and after radiotherapy by applying CT radiomics features, establish a relationship between the changes in radiomics features and radiation dose and to provide basis for early prediction of radiation myocardial injury.Methods Eighty patients with esophageal cancer who had undergone radiotherapy in Shandong Tumor Hospital from May 28,2017 to June 28,2021 were selected in this study, and CT imaging before and after radiotherapy were obtained.The left ventricular myocardial was delineated as regions of interest(ROI) under dose gradients of 0-10,10-20,20-30,30-40,40-50 and >50 Gy.The radiomics features of each ROI were extracted and stable features were screened, and the changes in radiomics features before and after radiotherapy under different dose gradients were compared.Results At each dose gradient, 93 imaging features were extracted and 87 stable features were screened.There were 8 features with statistically significant difference at different dose gradients before and after radiotherapy(Z=-2,445-1.964,P=0.019-0.049),in which the number of features was the largest at 20-30 Gy(6),and GLCM ClusterShade had the highest change rate(1 138.67%).There was only one common feature GLSZM ZoneEntropy under the gradient of 10-20,20-30,30-40,and 40-50 Gy, with a change rate of 2.87%,2.32%,2.61%,and 5.19%,respectively.The changes of GLSZM ZoneEntropy first decreased and then increased following dose escalation, and the overall trend was upward.Conclusion CT radiomics features reveal microscopic changes in left ventricular myocardial after radiotherapy, which provide reference for early prediction of radiation myocardial injury.The changes of imaging features in 20-30 Gy are the most significant, and the dose in this range must be controlled in the design of radiotherapy plan for esophageal cancer.
作者
徐菁
巩贯忠
杨厚义
钟慧
尹勇
XU Jing;GONG Guanzhong;YANG Houyi;ZHONG Hui;YIN Yong(Graduate School,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China;Department of Radiation Physics,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2023年第6期375-380,共6页
Chinese Journal of Cancer Prevention and Treatment
基金
山东省泰山学者(2017XZC1206)。
关键词
食管癌
影像组学
心肌损伤
放射治疗
esophageal cancer
radiomics
myocardial injury
radiation therapy
