Tumour heterogeneity in oesophageal cancer assessed by CT texture analysis: Preliminary evidence of an association with tumour metabolism, stage, and survival
Tumour heterogeneity in oesophageal cancer assessed by CT texture analysis: Preliminary evidence of an association with tumour metabolism, stage, and survival
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DOI：
10.1016/j.crad.2011.08.012
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发表时间：
2012-02-01
影响因子：
2.6
通讯作者：
Miles, K.
中科院分区：
文献类型：
--
作者：
Ganeshan, B.;Skogen, K.;Miles, K.
目的：进行一项初步研究，评估使用计算机断层扫描纹理分析（CTTA）评估的肿瘤异质性是否有可能为食管癌的肿瘤侵袭性和预后提供标志物。
材料与方法：对21例患者，使用正电子发射断层扫描（PET） - CT检查获得的原发性食管病变的平扫CT图像进行CTTA。CTTA使用一种软件算法进行，该算法在滤波值1.0（精细细节）和2.5（粗糙特征）之间选择性地过滤和提取不同解剖尺度的纹理，并将其量化为熵和均匀度（衡量图像异质性）。纹理参数与平均肿瘤2 - [F - 18] - 氟 - 2 - 脱氧 - D - 葡萄糖（FDG）摄取[标准化摄取值（平均SUV和最大SUV）]以及由内镜超声（淋巴结受累情况）和PET - CT（远处转移）确定的临床分期相关。使用卡普兰 - 迈耶分析评估肿瘤分期、FDG摄取和纹理与生存之间的关系。
结果：肿瘤异质性与最大SUV和平均SUV相关。对于以均匀度和熵衡量的平均SUV与粗糙滤波，发现相关性最为密切（分别为r = -0.754，p < 0.0001；r = 0.748，p = 0.0001）。在临床分期为III或IV期的患者中，对于滤波值在1.0和2.0之间，异质性也显著更大（滤波值1.5时差异最大：熵：p = 0.027；均匀度p = 0.032）。中位（范围）生存期为21（4 - 34）个月。通过CTTA（粗糙均匀度）评估的肿瘤异质性是生存期的独立预测因子[比值比（OR）= 4.45（95%置信区间：1.08，18.37）；p = 0.039]。
结论：CTTA对肿瘤异质性的评估有可能识别具有不良生物学特征的食管癌，并提供生存期的预后指标。（C）2011英国皇家放射学院。由爱思唯尔有限公司出版。保留所有权利。
AIM: To undertake a pilot study assessing whether tumour heterogeneity evaluated using computed tomography texture analysis (CTTA) has the potential to provide a marker of tumour aggression and prognosis in oesophageal cancer.MATERIALS AND METHODS: In 21 patients, unenhanced CT images of the primary oesophageal lesion obtained using positron-emission tomography (PET)-CT examinations underwent CTTA. CTTA was carried out using a software algorithm that selectively filters and extracts textures at different anatomical scales between filter values 1.0 (fine detail) and 2.5 (coarse features) with quantification as entropy and uniformity (measures image heterogeneity). Texture parameters were correlated with average tumour 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) uptake [standardized uptake values (SUVmean and SUVmax)] and clinical staging as determined by endoscopic ultrasound (nodal involvement) and PET-CT (distant metastases). The relationship between tumour stage, FDG uptake, and texture with survival was assessed using Kaplan-Meier analysis.RESULTS: Tumour heterogeneity correlated with SUVmax and SUVmean. The closest correlations were found for SUVmean measured as uniformity and entropy with coarse filtration (r = -0.754, p < 0.0001; and r = 0.748, p = 0.0001 respectively). Heterogeneity was also significantly greater in patients with clinical stage III or IV for filter values between 1.0 and 2.0 (maximum difference at filter value 1.5: entropy: p = 0.027; uniformity p = 0.032). The median (range) survival was 21 (4-34) months. Tumour heterogeneity assessed by CTTA (coarse uniformity) was an independent predictor of survival [odds ratio (OR)=4.45 (95% CI: 1.08, 18.37); p = 0.039].CONCLUSION: CTTA assessment of tumour heterogeneity has the potential to identify oesophageal cancers with adverse biological features and provide a prognostic indicator of survival. (C) 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.