Fractal Analysis of Contrast-Enhanced CT Images to Predict Survival of Patients with Hepatocellular Carcinoma Treated with Sunitinib
Fractal Analysis of Contrast-Enhanced CT Images to Predict Survival of Patients with Hepatocellular Carcinoma Treated with Sunitinib
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DOI：
10.1007/s10620-014-3064-z
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发表时间：
2014-08-01
影响因子：
3.1
通讯作者：
Sahani, Dushyant V.
中科院分区：
文献类型：
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作者：
Hayano, Koichi;Yoshida, Hiroyuki;Sahani, Dushyant V.
肿瘤内异质性是恶性肿瘤的一个公认的特征。使用对比增强计算机断层扫描 (CE-CT) 图像的分形分析来评估肿瘤的异质性，以预测接受舒尼替尼治疗的肝细胞癌 (HCC) 患者的生存。患者队列包括 23 名 HCC 患者（19 名男性，4 名女性；平均年龄 61.5 岁），他们在基线时和一个周期后接受了 CE-CT舒尼替尼。使用 ImageJ 插件软件（NIH，贝塞斯达，马里兰州）分析动脉期 (AP) 和门脉期 (PP) CE-CT 图像。采用差分盒计数法计算肿瘤的分形维数（FD）。将肿瘤 FD、密度和大小与生存率进行比较。中位无进展生存期 (PFS) 为 4.43 个月。患者被分为有利的 PFS 组（PFS > 4.43 个月；9 名患者）和不利的 PFS 组（PFS 为千分之一货币符号 4.43；13 名患者）。良好 PFS 组的 AP 和 PP 图像的基线 FD 均低于不良 PFS 组（均 P = 0.03）。 PFS 有利组和不利组之间 AP 图像上 FD 的变化存在显着差异（P = 0.02）。肿瘤密度和大小与 PFS 没有显着相关性。在 Kaplan-Meier 分析中，基线 AP 图像上显示较低 FD 的肿瘤患者表现出较长的 PFS (P = 0.002)。一个治疗周期后，PP 图像上 FD 显着降低的肿瘤患者显示出更长的总生存期 (P = 0.002)。CE-CT 图像上肿瘤的 FD 可能是舒尼替尼治疗 HCC 患者的有用生物标志物。
Intratumoral heterogeneity is a well-recognized feature of malignancy.To assess the heterogeneity of tumor using fractal analysis of contrast-enhanced computed tomography (CE-CT) images for predicting survival of hepatocellular carcinoma (HCC) patients treated with sunitinib.The patient cohort comprised 23 patients (19 men, 4 women; mean age 61.5 years) with HCC who underwent CE-CT at baseline and after one cycle of sunitinib. Arterial-phase (AP) and portal-phase (PP) CE-CT images were analyzed using a plugin software for ImageJ (NIH, Bethesda, MD). A differential box-counting method was employed to calculate the fractal dimension (FD) of the tumor. Tumor FD, density, and size were compared with survival.Median progression-free survival (PFS) was 4.43 months. Patients were grouped into a favorable PFS (PFS > 4.43 months; 9 patients) and an unfavorable PFS group (PFS a parts per thousand currency sign4.43; 13 patients). The baseline FD on both the AP and PP images was lower in the favorable PFS group than in the unfavorable PFS group (both P = 0.03). There was a significant difference in the change of the FD on the AP image between the favorable and unfavorable PFS groups (P = 0.02). Tumor density and size showed no significant correlations with PFS. In the Kaplan-Meier analysis, patients with tumors showing lower FD on the AP image at baseline showed longer PFS (P = 0.002). Patients with tumors showing a greater reduction in the FD on the PP image after one cycle of the therapy showed longer overall survival (P = 0.002).The FD of the tumor on CE-CT images may be a useful biomarker for HCC patients treated with sunitinib.