QSM三维直方图分析评估成人型弥漫性胶质瘤IDH基因型及肿瘤增殖活性  

Three-dimensional histogram analysis of quantitative susceptibility mapping (QSM) for evaluating IDHgenotypes and tumor proliferation in adult-type diffuse gliomas

作　　者：孙祎繁 杨哲婷 邓凯吉 耿莹茜 胡晓梅 蒋日烽[1] SUN Yi-fan;YANG Zhe-ting;DENG Kai-ji(Department of Radiology,Fujian Medical University Union Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学附属协和医院影像科,福建福州350001 [2]福建医科大学附属协和医院病理科,福建福州350001

出　　处：《放射学实践》2023年第12期1520-1525,共6页Radiologic Practice

基　　金：福建省自然科学基金面上项目(2022J01252);福建医科大学启航基金项目(2021QH1025)。

摘　　要：目的:探讨基于定量磁敏感图(QSM)提取的直方图特征在评估成人型弥漫性胶质瘤的异柠檬酸脱氢酶(IDH)基因型及肿瘤细胞增殖活性中的价值。方法:回顾性分析2019年1月-2022年1月在本院经手术病理证实的47例弥漫性胶质瘤患者的临床资料及磁共振QSM扫描数据。其中,IDH突变型20例,IDH野生型27例。采用ImageJ软件,于肿瘤实体区域逐层勾画ROI后生成三维容积ROI(VOI),提取每个VOI在QSM上的12个直方图特征。采用Mann-Whitney U检验比较IDH突变型与IDH野生型之间各直方图特征的差异,并采用ROC曲线分析各直方图特征的诊断效能。利用Spearman检验分析各直方图特征与Ki-67标记指数(Ki-67 LI)的相关性。结果:7个QSM直方图参数,包括第10百分位数(P10)、P90、四分位数间距(IQR)、最大值(Max)、平均绝对偏差(MAD)、均方根(RMS)及方差(Var),在不同IDH突变型和野生型之间的差异具有统计学意义(P<0.05),其中IQR的诊断效能最佳,AUC为0.774,诊断敏感度和特异度分别为70.0%和81.5%。8个QSM特征与Ki-67 LI有显著相关性(P<0.05),其中以IQR的相关性最高(r=0.531,P<0.001)。结论:QSM三维直方图分析在评估成人型弥漫性胶质瘤IDH基因型方面具有较好的效能,还可在一定程度上反映肿瘤细胞的增殖活性。Objective:To investigate the value of quantitative susceptibility mapping(QSM)histogram features in evaluating the isocitrate dehydrogenase(IDH)genotypes and tumor cell proliferation in adult-type diffuse gliomas.Methods:Retrospective analysis of case data and QSM scan data of 47 cases of surgically pathologically confirmed diffuse gliomas in our hospital from January 2019 to January 2022,including 20 cases of IDH mutant type and 27 cases of IDH wild-type.The ImageJ software was used to delineate the region of interest(ROI)over the tumor parenchyma slice by slice,and the ROIs of each slice were merged into a three-dimensional VOI,and the 12 QSM histogram features of the VOI were extracted.The Mann-Whitney U test was used to compare the difference in histogram features between different IDH genotypes.Receiver operating characteristic(ROC)curves were constructed to assess the corresponding diagnostic performance.The correlations between each histogram feature and Ki-67 labeling index(Ki-67 LI)were evaluated using Spearman′s test.Results:Seven QSM histogram features,including the 10th percentile(P10),P90,interquartile range(IQR),maximum,mean absolute deviation(MAD),root mean square(RMS)and variance,showed significant differences(P<0.05)among different IDH genotypes,with IQR had the best diagnostic efficacy with an AUC value of 0.774 and diagnostic sensitivity and specificity of 70.0%and 81.5%,respectively.Eight QSM features correlated statistically with Ki-67 LI(P<0.05),IQR had the largest correlation coefficient(r=0.531,P<0.001).Conclusion:QSM three-dimensional histogram analysis shows good efficacy in evaluating the IDH genotypes of adult-type diffuse gliomas and can assist in reflecting the tumor cell proliferation to a certain extent.

关 键 词：定量磁敏感图 胶质瘤 脑肿瘤 异柠檬酸脱氢酶 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]