CT增强图像纹理分析对食管癌术后早期复发转移的预测价值

Predictive value of texture analysis based on enhanced CT images for early recurrence and metastasis of esophageal squamous cell carcinoma after surgery

目的探讨CT增强图像纹理分析对食管鳞癌患者术后早期复发转移的预测价值。方法选取2016年1月至2018年12月于我院经病理活检证实为食管鳞癌的患者。将增强CT图像(动脉期和静脉期)数据导入FireVoxel软件进行纹理分析,记录各纹理参数值包括均值、中位数、标准差、异质性、偏度、峰度、熵值。依据随访术后1年有无复发转移分为早期术后复发转移组(ERM组)和非早期术后复发转移组(NERM组),分别比较动脉期和静脉期两组间纹理参数差异,利用ROC曲线分析CT纹理参数对术后早期复发转移的预测效能。结果最终共纳入49例患者,其中ERM组18例,NERM组31例。动脉期熵值在两组间的差异有统计学意义(P <0.05);静脉期不均匀度、熵值在两组间的差异有统计学意义(P <0.05)。动脉期熵值诊断食管癌术后早期复发与转移的曲线下面积为0.772,最佳临界值为3.893;静脉期熵值曲线下面积为0.801,最佳临界值为3.905,其敏感度为66.7%,特异度为87.1%,对于食管癌术后早期复发与转移的诊断具有一定的准确性。结论增强CT图像(尤其是静脉期)的纹理分析在预测食管癌术后早期复发转移上具有可行性,为食管癌术前无创性预测术后早期复发转移提供帮助。

Objective To investigate the predictive value of texture analysis based on enhanced CT images for early recurrence and metastasis in patients with esophageal squamous cell carcinoma after surgery.Methods Patients with esophageal squamous cell carcinoma confirmed by pathological biopsy in our hospital from January 2016 to December 2018 were selected.The enhanced CT image data(arterial phase and venous phase)were imported into FireVoxel software for texture analysis,and the values of each texture parameter including mean,median,stan⁃dard deviation,heterogeneity,skewness,kurtosis,and entropy were recorded.According to the one⁃year follow⁃up,patients were divided into two groups:early postoperative recurrence and metastasis group(ERM group),and non⁃early postoperative recurrence and metastasis group(NERM group).The differences of texture parameters between the two groups were compared,and ROC curve was used to analyze the prediction effect of CT texture param⁃eters on early postoperative recurrence and metastasis.Results A total of 49 patients were included,18 in ERM group and 31 in NERM group.The difference of entropy between the two groups in arterial phase was statistically significant(P<0.05).The differences of inhomogeneity and entropy between the two groups in venous phase were statistically significant(P<0.05).The best critical value of entropy in arterial phase was 3.893 and the area under the curve was 0.772.The area under the entropy curve of venous phase was 0.801,the best critical value was 3.905,the sensitivity was 66.7%,and the specificity was 87.1%,which had a certain accuracy for the diagnosis of early recurrence and metastasis of esophageal cancer.Conclusion The texture analysis of enhanced CT images(especially the venous phase)is feasible in predicting early recurrence and metastasis of postoperative esophageal cancer,and it can help noninvasive prediction of early recurrence and metastasis of esophageal cancer after surgery.