基于^(18)F-FDG PET/CT纹理分析预测胰腺癌脉管侵犯状态  

Prediction of Lymphovascular Invasion in Resectable Pancreatic Cancer Based on^(18)F-FDG PET/CT Texture Analysis

作　　者：高艳 周维燕 黄琪 沈忱[3] 谭忠华[1] 孙春锋 GAO Yan;ZHOU Weiyan;HUANG Qi;SHEN Chen;TAN Zhonghua;SUN Chunfeng(Department of Nuclear Medicine,fliated Hospital of Nantong University;PET Center,Huashan Hospital,Fudan University;Department of General Surgery,filiated Hospital of Nantong University)

机构地区：[1]南通大学附属医院核医学科,南通226001 [2]复旦大学附属华山医院PET中心 [3]南通大学附属医院普外科

出　　处：《中国医学计算机成像杂志》2022年第6期653-657,共5页Chinese Computed Medical Imaging

基　　金：江苏省卫生健康委老年健康科研课题项目(LK2021019);南通市社会民生科技面上项目(MS12020043)。

摘　　要：目的:基于^(18)F-FDG PET/CT影像纹理特征预测胰腺导管腺癌(PDAC)脉管侵犯(LVI)状态。方法:分析24例PDAC患者术前^(18)F-FDG PET/CT检查图像,勾画肿瘤感兴趣体积(VOI)获得最大标准摄取值(SUVmax)和平均标准摄取值(SUVmean)、肿瘤病灶代谢体积(MTV)及病灶总糖酵解(TLG);LIFEx软件提取纹理特征后应用最大相关性最小冗余度(mRMR)以及最小绝对收缩和选择算子(LASSO)算法构建LVI预测模型,计算每个病灶基于PET、CT以及联合PETCT组学评分(包括PET-RS、CT-RS以及PETCT-RS),应用ROC曲线评估各参数对LVI预测效能。结果:(1)LVI阳性组的PETCT-RS、PET-RS、CT-RS、SUVmean及SUVmax均高于LVI阴性组(均P<0.05);(2)SUVmax、SUVmean、TLG同三种RS均呈不同程度正相关;(3)PETCT-RS、PET-RS、CT-RS、SUVmean及SUVmax预测LVI的ROC曲线下面积(AUC)分别为0.852、0.822、0.822、0.800、0.785(均P<0.05);(4)LVI阳性组的淋巴结转移比例高于LVI阴性组。结论:三种RS、SUVmax及SUVmean均可无创性预测胰腺癌LVI状态,PDAC脉管浸润可能增加淋巴结转移发生的风险。Purpose:To develop models for lymphovascular invasion(LVI)prediction in patients with pancreatic ductal adenocarcinoma(PDAC)based on^(18)F-FDG PET/CT radiomics.Methods:Twenty-four patients with the diagnosis of PDAC who underwent^(18)F-FDG PET/CT were evaluated retrospectively.Volume of interest(VOI)was delineated and the PET parameters including maximum standardized uptake value(SUVmax),mean standardized uptake value(SUVmean),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were recorded.After textural features extraction using the LIFEx software,the maximum relevance minimum redundancy(mRMR)and least absolute shrinkage and selection operator(LASSO)algorithms were used to construct the radiomics models.Radiomics scores(RS)for PET,CT and integrated PET/CT(PET-RS,CT-RS,PETCT-RS)were calculated accordingly.Receiver operating characteristic(ROC)curves were generated to obtain the efficiency of the abovementioned parameters and RSs for LVI prediction.Results:(1)PETCT-RS,PET-RS,CT-RS,SUVmean and SUVmax were associated with LVI status(all P<0.05);(2)SUVmax,SUVmean and TLG showed a moderate or high positive correlation with these three RSs;(3)The AUCs of PETCT-RS,PET-RS,CT-RS,SUVmean and SUVmax for LVI prediction were 0.852,0.822,0.822,0.800 and 0.785,respectively(all P<0.05);(4)The proportion of lymph node metastasis was higher in LVI-positive group than those in LVI-negative group.Conclusion:The three RSs,SUVmax and SUVmean,all showed favorable predictive ability for LVI status in patients with PDAC.LVI-positive will suggest the risk increase of lymph node metastasis in PDAC.

关 键 词：胰腺导管腺癌 正电子发射体层显像 影像组学 脉管侵犯 ^(18)F-氟脱氧葡萄糖 

分 类 号：R445.6[医药卫生—影像医学与核医学]