摘要
目的探讨^(18)F-氟脱氧葡萄糖(^(18)F-FDG)PET-CT影像组学方法鉴别中低分化肝细胞癌(HCC)和肝内胆管细胞癌(ICC)的可行性。方法本前瞻性研究对象为2015年6月至2018年4月在中山大学附属第三医院行^(18)F-FDG PET-CT检查的36例原发性肝癌患者。患者签署知情同意书,符合医学伦理学规定。其中男31例,女5例;年龄21～74岁,中位年龄52岁。中低分化HCC 26例,ICC 10例。利用3D Slicer软件在^(18)F-FDG PET-CT图像上勾画病灶感兴趣区体积,提取每个病灶的影像组学特征。105个影像组学特征经LASSO回归模型进行筛选和优化,构建影像组学标签诊断模型。采用受试者工作特征(ROC)曲线检验该模型在鉴别中低分化HCC和ICC中的诊断效能。结果每个病灶均得到105个PET-CT影像组学特征,筛选和优化后得到2个PET-CT影像组学特征Sphericity和Zone Variance,纳入Logistic回归模型,得到影像组学标签诊断模型为logit(P)=-8.984+10.506×Sphericity+61.341×ZoneVariance。该模型的ROC曲线下面积为0.923,95%CI:0.84～1.00,敏感度为1.00,特异度为0.73。结论 ^(18)F-FDG PET-CT影像组学能较好地鉴别中低分化HCC和ICC,具有较高的敏感度和特异度,诊断价值高。
Objective To investigate the feasibility of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography with computed tomography (PET-CT) radiomics in the differential diagnosis of moderately- or poorly-differentiated hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC). Methods In this prospective study, 36 patients with primary liver cancer receiving 18F-FDG PET-CT in the Third Affiliated Hospital of Sun Yat-sen University from June 2015 to April 2018 were recruited. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 31 patients were male and 5 female, aged 21-74 years with a median age of 52 years. 26 patients were diagnosed with moderately- or poorly-differentiated HCC and 10 of ICC. The volume of region of interests on the 18F-FDG PET-CT images was delineated by using 3D Slicer software. The radiomic features of each lesion were extracted. A total of 105 radiomic features were screened and optimized by LASSO regression model to construct a diagnostic model with radiomics signatures. The efficacy of this model in differential diagnosis from moderately- or poorly-differentiated HCC and ICC was evaluated by the receiver operating characteristic (ROC) curve. Results In total, 105 PET-CT radiomic features were obtained for each lesion. After screening and optimization, 2 PET-CT radiomic features, Sphericity and ZoneVariance, were sorted and included into the Logistic regression model. The diagnostic model with radiomics signatures was logit (P)=-8.984+10.506× Sphericity+61.341×ZoneVariance. The area under ROC curve of this model was 0.923, 95%CI: 0.84-1.00, with the sensitivity 1.00 and specificity 0.73. Conclusions 18F-FDG PET-CT radiomics can be adopted to differentiate moderately- or poorly-differentiated HCC from ICC with a high sensitivity, specificity and diagnostic value.
作者
周子东
查悦明
黄文山
杨敏
张桂雄
许杰华
Zhou Zidong;Zha Yueming;Huang Wenshan;Yang Min;Zhang Guixiong;Xu Jiehua(Department of Nuclear Medicine,the Third AffiliatedHospital of Sun Yat-sen University,Guangzhou 510630,China)
出处
《中华肝脏外科手术学电子杂志》
CAS
2019年第2期154-158,共5页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
国家自然科学基金(81101866)
广东省自然科学基金(2018A030313200)
关键词
癌
肝细胞
胆管上皮癌
正电子发射断层显像术
影像组学
Carcinoma, hepatocellular
Cholangiocarcinoma
Positron-emission tomography
Radiomics
