Differentiating hypovascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinoma based on CT texture analysis
Differentiating hypovascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinoma based on CT texture analysis
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基于CT纹理分析鉴别缺血管性胰腺神经内分泌肿瘤与胰腺导管腺癌
DOI：
10.1177/0284185119875023
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发表时间：
2020-05
期刊：
影响因子：
1.3
通讯作者：
Wang Z
中科院分区：
文献类型：
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作者：
Wang Z;Chen X;Wang J;Cui W;Ren S;Wang Z
背景少血管胰腺神经内分泌瘤常误诊为胰腺导管腺癌。目的探讨CT增强扫描图像纹理分析在胰腺神经内分泌瘤与胰腺导管腺癌鉴别诊断中的应用价值。材料与方法21例低血管胰腺神经内分泌肿瘤和63例胰腺导管腺癌患者的临床资料。所有患者均行术前平扫和动态增强CT检查。两名放射科医生使用纹理分析软件对胰腺实质和门脉期CT图像进行独立和手动勾画每个病变的感兴趣区域。经多因素Logistic回归分析，找出区分低血管胰腺神经内分泌瘤和胰腺导管腺癌的显著特征。对受试者的工作特性曲线进行分析，以确定诊断能力。结果CT纹理特征包括：均方根(OR[OR] = 0.50，P<；0.001)、量化(Quantile50，OR = 1.83，P<；0.001)、求和(OR = 0.92，P=0.007)；门脉相“对比度”(OR = 6.08，P<；0.001)。曲线下面积分别为RMS0.76(敏感度 = 0.75，特异度 = 0.67)，Quantile50(敏感度 = 0.60，特异度 = 0.77)0.73，总和0.70(敏感度 = 0.65，特异度 = 0.82)，综合纹理特征0.85(敏感度 = 0.77，特异度 = 0.85)。结论CT纹理分析有助于胰腺神经内分泌瘤与胰腺导管腺癌的鉴别诊断。这三种纹理特征的组合表现出了可接受的诊断性能。
Background Hypovascular pancreatic neuroendocrine tumor is usually misdiagnosed as pancreatic ductal adenocarcinoma. Purpose To investigate the value of texture analysis in differentiating hypovascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinoma on contrast-enhanced computed tomography (CT) images. Material and Methods Twenty-one patients with hypovascular pancreatic neuroendocrine tumors and 63 patients with pancreatic ductal adenocarcinomas were included in this study. All patients underwent preoperative unenhanced and dynamic contrast-enhanced CT examinations. Two radiologists independently and manually contoured the region of interest of each lesion using texture analysis software on pancreatic parenchymal and portal phase CT images. Multivariate logistic regression analysis was performed to identify significant features to differentiate hypovascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas. Receiver operating characteristic curve analysis was performed to ascertain diagnostic ability. Results The following CT texture features were obtained to differentiate hypovascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas: RMS (root mean square) (odds ratio [OR] = 0.50, P<0.001), Quantile50 (OR = 1.83, P<0.001), and sumAverage (OR = 0.92, P=0.007) in parenchymal images and “contrast” in portal phase images (OR = 6.08, P<0.001). The areas under the curves were 0.76 for RMS (sensitivity = 0.75, specificity = 0.67), 0.73 for Quantile50 (sensitivity = 0.60, specificity = 0.77), 0.70 for sumAverage (sensitivity = 0.65, specificity = 0.82), 0.85 for the combined texture features (sensitivity = 0.77, specificity = 0.85). Conclusion CT texture analysis may be helpful to differentiate hypovascular pancreatic neuroendocrine tumors from pancreatic ductal adenocarcinomas. The three combined texture features showed acceptable diagnostic performance.
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