PET/MR影像组学和代谢参数在评价鼻咽癌分期中的价值研究

Application Value of PET/MR Radiomics Features and Metabolic Parameters in Evaluating the Staging of Nasopharyngeal Carcinoma

目的探讨基于PET/MR的鼻咽癌原发灶影像组学特征和最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)、糖酵解总量(TLG)3个代谢参数在评价鼻咽癌分期中的临床价值。方法回顾性分析连续100例鼻咽癌患者PET/MR影像学资料和临床资料,测量所有鼻咽癌患者原发灶的代谢参数,提取与鼻咽癌分期最相关的影像组学特征。将所选代谢参数和影像组学特征分别与鼻咽癌T分期、N分期及临床分期进行相关性分析。对有统计学意义的参数和特征通过ROC曲线评价它们在鼻咽癌分期中的诊断效能。结果从PET/MR图像中共提取了9个最相关的影像组学特征。代谢参数、所选组学特征与T分期和临床分期有不同程度相关性,而与N分期均无相关性。MTV、TLG、T_(2)WI组学特征(MinIntensity)、PET组学特征(GLCMEntropy_angle0_offset4)在T分期的组间和组内比较差异均有统计学意义(P<0.05),它们对鉴别鼻咽癌T分期有较高的诊断效能(曲线下面积:0.785~0.956)。TLG、PET组学特征(GLCMEntropy_angle0_offset4)在临床分期的组间和组内比较差异有统计学意义(P<0.05),二者对鉴别鼻咽癌临床分期有较高的诊断效能(曲线下面积:0.775~0.953)。结论基于PET/MR的鼻咽癌原发灶影像组学特征和代谢参数对评价鼻咽癌T分期和临床分期有重要价值,但在N分期中的价值有限。

Objective To explore the clinical value of positron emission tomography/magnetic resonance(PET/MR)-based radiomics features and the three metabolic parameters of maximum standardized uptake value(SUVmax),tumor metabolic volume(MTV),and total glycolysis(TLG)in evaluating the staging of primary nasopharyngeal carcinoma(NPC).Methods The PET/MR imaging and clinical data of 100 consecutive cases with NPC were analyzed in our hospital;The metabolic parameters of the primary focus were assessed,and the relevant radiomics features of NPC staging were extracted.The correlation analysis evaluated the selected metabolic parameters,radiomics features and the stage of NPC.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the statistically significant parameters and features.Results A total of 9 most relevant radiomics features were extracted from PET/MR.The metabolic parameters and selected radiomics features were related to T stage and clinical stage,but not to N stage.The metabolic tumor volume(MTV),total lesion glycolysis(TLG),T_(2)WI radiomics features(MinIntensity),and PET radiomics features(GLCMEntropy_angle0_offset4)showed statistically significant differences among groups and within the group of T stage(P<0.05)with a high diagnostic efficiency for identifying the T staging(area under the ROC curve(AUC):0.785-0.956).TLG and PET radiomics features(GLCMEntropy_angle0_offset4)differed significantly among groups and within a group of clinical stages(P<0.05)along with high diagnostic efficacy for identifying clinical stages(AUC:0.775-0.953).Conclusion PET/MR radiomics features and metabolic parameters of primary NPC are critical for evaluating the T and clinical stage of NPC,but are of limited value in the N stage.