^(18)F-FDG PET/MR影像组学特征与宫颈癌PD-L1表达的相关性研究  

Correlation study between ^(18)F-FDG PET/MR imaging radiomic features and PD-L1 expression in cervical cancer

作　　者：李旺 李朗俊 刘卓男 孙洪赞[1] LI Wang;LI Langjun;LIU Zhuonan;SUN Hongzan(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110022

出　　处：《磁共振成像》2024年第7期32-38,45,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：沈阳市中青年科技创新人才支持计划项目(编号:RC210138)。

摘　　要：目的 探讨^(18)F-氟代脱氧葡萄糖(fluorodeoxyglucose, FDG)正电子发射断层成像(positron emission tomography,PET)/MR影像组学特征与宫颈癌程序性死亡受体配体1(programmed death-ligand 1, PD-L1)表达的相关性。材料与方法 回顾性分析中国医科大学附属盛京医院2017年5月至2023年7月进行了^(18)F-FDG PET/MR扫描的26例宫颈癌患者临床和影像资料,在PET,T1WI及T2WI的图像中对原发灶进行感兴趣区(region of interest, ROI)勾画,将每个患者的每个包含ROI横截面作为样本,以手术标本取样染色,将样本分为阳性组(n=233,73.97%)、阴性组(n=82,26.03%),并基于一阶统计量(Firstorder)从图像中提取影像组学特征。采用独立样本t检验或Mann-Whitney U检验比较两组间特征参数的差异,并分析图像特征参数与PD-L1表达的相关性。将样本按照7∶3的比例随机划分为训练集和测试集,将差异有统计学意义的组学特征作为逻辑回归的参数建立PET影像组学模型、MR影像组学模型及PET/MR联合模型,通过受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(areaunderthecurve, AUC)分析评估各模型对PD-L1表达诊断的效能。结果 PET图像参数10Percentile (P<0.01)、 90Percentile (P<0.01)、 Energy (P<0.01)、 Interquartile Range (P<0.01)等15个一阶统计量特征与PD-L1表达具有较强的相关性,T1WI图像参数10Percentile (P<0.01)、90Percentile (P<0.05)、Maximum (P<0.05)、Mean(P<0.01)等9个一阶统计量特征与PD-L1表达具有较强的相关性,T2WI图像参数Entropy(P<0.05)、Skewness(P<0.01)、Energy(P<0.05)、Interquartile Range(P<0.01)等9个一阶统计量特征与PD-L1表达具有较强的相关性。在影像组学模型中,训练集PET组学模型、MR组学模型及PET/MR联合模型AUC值分别为0.478 [95%置信区间(confidence interval, CI):0.389~0.565]、0.806(95%CI:0.728~0.874)、0.850(95%CI:0.784~0.909)。测试集PET组学模型、MR组学模型及PET/MR联合模型AUC值分�Objective:To explore the correlation between ^(18)F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/MR radiomic features and the expression of programmed death-ligand 1(PD-L1)in cervical cancer.Materials and Methods:A retrospective analysis was conducted on 26 cervical cancer patients who underwent ^(18)F-FDG PET/MR scans at Shengjing Hospital,China Medical University,from May 2017 to July 2023.Regions of interest(ROIs)were delineated on the images of the primary lesions in PET,T1WI,and T2WI.Each cross-sectional image containing an ROI for each patient was treated as a sample.Based on sampling and staining of surgical specimens,the samples were divided into a positive group(n=233,73.97%)and a negative group(n=82,26.03%).Radiomic features were extracted from the images using first-order statistics.Independent sample t-tests or Mann-Whitney U tests were used to compare the differences in feature parameters between the two groups.The correlation between image feature parameters and PD-L1 expression was analyzed.The samples were randomly divided into training and testing sets in a 7∶3 ratio.Radiomic features with statistically significant differences were used as parameters to establish PET radiomic models,MR radiomic models,and PET/MR combined models through logistic regression.The diagnostic performance of each model for PD-L1 expression was evaluated using the area under the curve(AUC)analysis of receiver operating characteristic(ROC)curves.Results:The 15 first-order statistical features of PET images,including 10Percentile(P<0.01),90Percentile(P<0.01),Energy(P<0.01),Interquartile Range(P<0.01),and others,exhibit a strong correlation with PD-L1 expression.Similarly,the T1WI image parameters,such as 10Percentile(P<0.01),90Percentile(P<0.05),Maximum(P<0.05),Mean(P<0.01),and nine other first-order statistical features,show a strong correlation with PD-L1 expression.Additionally,the T2WI image parameters,including Entropy(P<0.05),Skewness(P<0.01),Energy(P<0.05),Interquartile Range(P<0.01),and eight other fi

关 键 词：妇科肿瘤 宫颈癌 程序性死亡受体配体1 影像组学 磁共振成像 正电子发射断层成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.33[医药卫生—诊断学]