伴髓样特征乳腺癌与乳腺纤维腺瘤超声表现的影像组学对比研究

Ultrasonographic radiomics in differential diagnosis of breast carcinoma with medullary features and breast fibroadenoma

目的对比伴髓样特征乳腺癌与乳腺纤维腺瘤超声影像组学特征,挖掘鉴别诊断的定量参数,为临床诊疗提供影像学依据。方法收集2015年1月—2019年12月于天津医科大学肿瘤医院乳腺影像诊断科行乳腺超声检查并经手术病理证实为伴髓样特征乳腺癌的43个病变的超声图像。随机抽取同一时期行乳腺超声检查并经手术病理证实为乳腺纤维腺瘤的129个病变的超声图像作为对照组。分别提取2组超声图像的影像组学特征参数,比较2组参数的差异,采用受试者工作特征(ROC)曲线分析差异有统计学意义的参数的诊断效能。结果伴髓样特征乳腺癌与乳腺纤维腺瘤相比纵横比更大(0.623 vs.0.495),凹性率更大(0.107 vs.0.047),灰度均值更小(35.651 vs.49.990),相关性更小(0.903 vs.0.935),同质性更小(0.780 vs.0.811),差异均有统计学意义(P<0.01)。纵横比、凹性率和相关性的曲线下面积及准确度相对较高,可达0.70左右。纵横比、凹性率、灰度均值、相关性和同质性的敏感度均较高,可达0.80以上,但特异度均较低。结论超声影像组学特征参数能为伴髓样特征乳腺癌与乳腺纤维腺瘤的鉴别诊断提供依据,具有一定的临床意义。

ObjectiveTo compare the ultrasonographic radiomics features of breast carcinoma with medullary features(CMF)and breast fibroadenoma(FA),and to comfirm the quantitative parameters of differential diagnosis so as to provide the imaging basis for clinical diagnosis and treatment.Methods Data of ultrasonographic images containing 43 CMF lesions and 129 FA lesions(control group)confirmed by pathology from January 2015 to December 2019 were retrospectively analyzed.Radiomics features were evaluated and compared between the two groups.The area under the curve,cut-off value,accuracy,sensitivity,specificity,positive predictive value and negative predictive value were calculated.Results The aspect ratio(0.623 vs.0.495)and concavity rate(0.107 vs.0.047)were higher in CMF group than those of FA group.The gray mean value(35.651 vs.49.990),correlation(0.903 vs.0.935)and homogeneity(0.780 vs.0.811)were lower in CMF group than those of FA group(P<0.01).The AUC and accuracy of aspect ratio,concavity rate and correlation were relatively higher,which can reach to 0.70.The sensitivity of aspect ratio,concavity rate,gray mean value,correlation and homogeneity were higher,and which can be up to 0.80,but the specificity was lower.ConclusionThe aspect ratio,concavity rate,gray mean value,correlation and homogeneity of ultrasonographic radiomics features provide evidence for the differential diagnosis of breast carcinoma with medullary features and breast fibroadenoma,and which has certain clinical significance.