腮腺多序列MR影像组学预测鼻咽癌急性放射性口干分级  

Prediction of acute radiation-induced xerostomia grading of nasopharyngeal carcinoma based on multi-sequence MRI radiomics of the parotid gland

作　　者：秦永辉[1] 尹勇 仇清涛 黄莉[1] 王若峥[1] QIN Yong-hui;YIN Yong;QIU Qing-tao;HUANG Li;WANG Ruo-zheng(Department of Head and Neck Comprehensive Radiotherapy,Cancer Hospital Affiliated to Xinjiang Medical University(Third Clinical Medical College),Key Laboratory of Cancer Immunology and Radiotherapy Research,ChineseAcademy of Medical Sciences,Key Laboratory of Xinjiang Oncology,Urumqi 830011,China;Department of Radiation Physics,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan250117,China)

机构地区：[1]新疆医科大学附属肿瘤医院(第三临床医学院)头颈综合放疗科,中国医学科学院肿瘤免疫与放疗研究重点实验室,新疆肿瘤学重点实验室,新疆乌鲁木齐830011 [2]山东省肿瘤防治研究院(山东省肿瘤医院)放射物理技术科,山东第一医科大学(山东省医学科学院),山东济南250117

出　　处：《中华肿瘤防治杂志》2022年第22期1599-1605,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：新疆维吾尔自治区科技支疆项目(2020E0265)。

摘　　要：目的探讨鼻咽癌放疗前后腮腺多序列MR影像组学特征与急性放射性口干分级的关联性,为急性放射性口干的预测提供依据。方法回顾性分析2020-01-01-2021-10-31新疆医科大学附属肿瘤医院收治的154例鼻咽癌患者,所有患者均于放疗前、后行MRI扫描,获取T1加权成像(T1WI)、T2加权成像(T2WI)、T1增强(T1C)图像。在不同序列MR图像上勾画患侧腮腺(iPG)、健侧腮腺(cPG)作为感兴趣区域(ROI),每个ROI提取851个影像特征,结合患者放疗后急性口干分级情况,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),分析腮腺多序列MR影像组学与急性放射性口干分级的关联性。结果154例患者放疗后发生非重度口干38例,重度口干116例,其中2级90例,3级26例,未出现4级口干。单因素分析结果显示,患者性别、T分期、N分期、M分期、临床分期、WHO病理分型和腮腺体积与口干分级无统计学关联(均P>0.05),年龄与急性放射性口干有统计学关联,χ^(2)=5.946,P=0.015。放疗前各序列MR影像组学特征与急性放射性口干分级无统计学关联(无AUC>0.7的特征);放疗后各序列MR影像组学与急性放射性口干分析中,AUC>0.7的特征仅有1个,为iPG-T1序列图像的wavelet-LLH-firstorder-Skewness,其AUC值、灵敏度和特异度分别为0.707(95%CI:0.608~0.807)、0.724和0.649;放疗前与放疗后AUC>0.7的特征T2序列最多,cPG-T2有12个,AUC值为0.704~0.727;iPG-T2有1个,特征为wavelet-LLH-firstorder-Skewnes,其AUC值、灵敏度和特异度分别为0.704(95%CI:0.615~0.792)、0.667和0.703。结论鼻咽癌放疗中MR影像组学特征与急性放射性口干具有关联性,其中以放疗前后影像组学特征变化最为显著,在监测腮腺功能变化及口干分级中首选cPG的T2WI影像组学特征。Objective To explore the correlation between the multi-sequential Magnetic Resonance(MR)imaging characteristics of the parotid gland and the grading of acute radiation xerostomia before and after radiotherapy for nasopharyngeal carcinoma,and to provide a basis for the prediction of acute radiation xerostomia.Methods Retrospective analysis was conducted on 154patients with nasopharyngeal carcinoma admitted to the Cancer Hospital Affiliated to Xinjiang Medical University from January 1,2020to October 31,2021.All patients underwent MRI scanning before and after radiotherapy to obtain T1weighted imaging(T1WI),T2weighted imaging(T2WI),and T1WI enhanced imaging(T1C).The affected ipsilateral parotid gland(iPG)and the healthy contralateral parotid gland(cPG)were delineated on different sequences of MR images as regions of interest(ROI).Then,851image features were extracted from each ROI.Combined with the grading of patients’acute xerostomia after radiotherapy,drawed the reciver operating characteristic(ROC)curve and calculated the area under curve(AUC),the correlation between the multi-sequential MR imaging of the parotid gland and the grading of acute xerostomia after radiotherapy was analyzed.Results Among 154patients,38patients suffered from acute non-severe dry mouth after radiotherapy,116patients suffered from severe dry mouth,including 90patients of grade 2and26patients of grade 3,without grade 4dry mouth.The results of univariate analysis showed that there was no statistical correlation between sex,T stage,N stage,M stage,clinical stage,WHO pathological classification and volume of the parotid gland and xerostomia grading(all P>0.05),but there was a statistical correlation between age and acute radiation xerostomia,χ^(2)=5.946,P=0.015.There was no statistical correlation between the characteristics of MR images of each sequence before radiotherapy and the grading of acute radiation xerostomia(no AUC>0.7).In the analysis of MR imaging radiomics and acute radiation xerostomia after radiotherapy,there was only one

关 键 词：鼻咽癌 腮腺 MRI 影像组学 急性放射性口干 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.63[医药卫生—诊断学]