非小细胞肺癌：CT 纹理参数的组织病理学相关性。
Non-small cell lung cancer: histopathologic correlates for texture parameters at CT.
机构信息
Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Brighton, England.
出版信息
Radiology. 2013 Jan;266(1):326-36. doi: 10.1148/radiol.12112428. Epub 2012 Nov 20.
PURPOSE
To correlate computed tomographic (CT) texture in non-small cell lung cancer (NSCLC) with histopathologic markers for angiogenesis and hypoxia.
MATERIALS AND METHODS
The study was institutional review board approved, and informed consent was obtained. Fourteen patients with NSCLC underwent CT prior to intravenous administration of pimonidazole (0.5 g/m(2)), a marker of hypoxia, 24 hours before surgery. Texture was assessed for unenhanced and contrast material-enhanced CT images by using a software algorithm that selectively filters and extracts texture at different anatomic scales (1.0 [fine detail] to 2.5 [coarse features]), with quantification of the standard deviation (SD) of all pixel values and the mean value of positive pixels (MPP) and uniformity of distribution of positive gray-level pixel values (UPP). After surgery, matched tumor sections were stained for angiogenesis (CD34 expression) and for markers of hypoxia (glucose transporter protein 1 [Glut-1] and pimonidazole). The percentage and average intensity of the tumor stained were assessed. A linear mixed-effects model was used to assess the correlations between CT texture and staining intensity.
RESULTS
SD and MPP quantified from medium to coarse texture on contrast-enhanced CT images showed significant associations with the average intensity of tumor staining with pimonidazole (for SD: filter value, 2.5; slope = 0.003; P = .0003). UPP (medium to coarse texture) on unenhanced CT images showed a significant inverse association with tumor Glut-1 expression (filter value, 2.5; slope = -115.13; P = .0008). MPP quantified from medium to coarse texture on both unenhanced and contrast-enhanced CT images showed significant inverse associations with tumor CD34 expression (unenhanced CT: filter value, 1.8; slope = -0.0008; P = .003; contrast-enhanced CT: filter value, 1.8; slope = -0.0006; P = .004).
CONCLUSION
Texture parameters derived from CT images of NSCLC have the potential to act as imaging correlates for tumor hypoxia and angiogenesis.
SUPPLEMENTAL MATERIAL
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112428/-/DC1.
目的
在非小细胞肺癌（NSCLC）中，将 CT 纹理与血管生成和缺氧的组织病理学标志物相关联。
材料与方法
本研究经机构审查委员会批准，并获得了患者的知情同意。14 例 NSCLC 患者在手术前 24 小时静脉注射 pimonidazole（0.5 g/m2）后进行 CT 检查。使用软件算法评估未增强和增强 CT 图像的纹理，该算法选择性地在不同解剖尺度（1.0 [精细细节] 至 2.5 [粗糙特征]）上过滤和提取纹理，量化所有像素值的标准差（SD）和阳性像素的平均值（MPP）以及阳性灰度像素值分布的均匀性（UPP）。手术后，对匹配的肿瘤切片进行血管生成（CD34 表达）和缺氧标志物（葡萄糖转运蛋白 1 [Glut-1]和 pimonidazole）染色。评估肿瘤染色的百分比和平均强度。使用线性混合效应模型评估 CT 纹理与染色强度之间的相关性。
结果
增强 CT 图像中中等至粗糙纹理的 SD 和 MPP 与肿瘤 pimonidazole 染色的平均强度有显著相关性（SD：滤值 2.5；斜率 0.003；P =.0003）。未增强 CT 图像中的 UPP（中等到粗糙纹理）与肿瘤 Glut-1 表达呈显著负相关（滤值 2.5；斜率 =-115.13；P =.0008）。未增强和增强 CT 图像中，从中等到粗糙纹理量化的 MPP 与肿瘤 CD34 表达呈显著负相关（未增强 CT：滤值 1.8；斜率=-0.0008；P =.003；增强 CT：滤值 1.8；斜率=-0.0006；P =.004）。
结论
从 NSCLC 的 CT 图像中提取的纹理参数有可能成为肿瘤缺氧和血管生成的影像学标志物。
补充材料
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112428/-/DC1.
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