透明细胞肾细胞癌（RCC）Fuhrman分级的CT预测：迈向计算机辅助诊断方法的发展
CT prediction of the Fuhrman grade of clear cell renal cell carcinoma (RCC): towards the development of computer-assisted diagnostic method.
作者信息
Huhdanpaa Hannu, Hwang Darryl, Cen Steven, Quinn Brian, Nayyar Megha, Zhang Xuejun, Chen Frank, Desai Bhushan, Liang Gangning, Gill Inderbir, Duddalwar Vinay
机构信息
Department of Radiology, University of Southern California, 1500 San Pablo St, 2nd floor imaging, Los Angeles, CA, 90033, USA.
Viterbi School of Engineering, University of Southern California, Los Angeles, USA.
出版信息
Abdom Imaging. 2015 Oct;40(8):3168-74. doi: 10.1007/s00261-015-0531-8.
PURPOSE
There are distinct quantifiable features characterizing renal cell carcinomas on contrast-enhanced CT examinations, such as peak tumor enhancement, tumor heterogeneity, and percent contrast washout. While qualitative visual impressions often suffice for diagnosis, quantitative metrics if developed and validated can add to the information available from standard of care diagnostic imaging. The purpose of this study is to assess the use of quantitative enhancement metrics in predicting the Fuhrman grade of clear cell RCC.
MATERIALS AND METHODS
65 multiphase CT examinations with clear cell RCCs were utilized, 44 tumors with Fuhrman grades 1 or 2 and 21 tumors with grades 3 or 4. After tumor segmentation, the following data were extracted: histogram analysis of voxel-based whole lesion attenuation in each phase, enhancement and washout using mean, median, skewness, kurtosis, standard deviation, and interquartile range.
RESULTS
Statistically significant difference was observed in 4 measured parameters between grades 1-2 and grades 3-4: interquartile range of nephrographic attenuation values, standard deviation of absolute enhancement, as well as interquartile range and standard deviation of residual nephrographic enhancement. Interquartile range of nephrographic attenuation values was 292.86 HU for grades 1-2 and 241.19 HU for grades 3-4 (p value 0.02). Standard deviation of absolute enhancement was 41.26 HU for grades 1-2 and 34.66 HU for grades 3-4 (p value 0.03). Interquartile range was 297.12 HU for residual nephrographic enhancement for grades 1-2 and 235.57 HU for grades 3-4 (p value 0.02), and standard deviation of the same was 42.45 HU for grades 1-2 and 37.11 for grades 3-4 (p value 0.04).
CONCLUSION
Our results indicate that absolute enhancement is more heterogeneous for lower grade tumors and that attenuation and residual enhancement in nephrographic phase is more heterogeneous for lower grade tumors. This represents an important step in devising a predictive non-invasive model to predict the nucleolar grade.
目的
在对比增强CT检查中，肾细胞癌具有明显的可量化特征，如肿瘤强化峰值、肿瘤异质性和对比剂洗脱百分比。虽然定性的视觉印象通常足以用于诊断，但如果开发并验证定量指标，则可以增加从标准护理诊断成像中获得的信息。本研究的目的是评估定量强化指标在预测透明细胞肾细胞癌Fuhrman分级中的应用。
材料与方法
利用65例透明细胞肾细胞癌的多期CT检查，其中44例肿瘤Fuhrman分级为1或2级，21例肿瘤分级为3或4级。在肿瘤分割后，提取以下数据：各期基于体素的全病灶衰减的直方图分析、使用均值、中位数、偏度、峰度、标准差和四分位数间距的强化和洗脱情况。
结果
在1-2级和3-4级之间观察到4个测量参数存在统计学显著差异：肾实质期衰减值的四分位数间距、绝对强化的标准差以及残余肾实质期强化的四分位数间距和标准差。1-2级肾实质期衰减值的四分位数间距为292.86HU，3-4级为241.19HU（p值0.02）。1-2级绝对强化的标准差为41.26HU，3-4级为34.66HU（p值0.03）。1-2级残余肾实质期强化的四分位数间距为297.12HU，3-4级为235.57HU（p值0.02），其标准差1-2级为42.45HU，3-4级为37.11（p值0.04）。
结论
我们的结果表明，较低分级肿瘤的绝对强化更不均匀，且较低分级肿瘤肾实质期的衰减和残余强化更不均匀。这是设计预测核仁分级的非侵入性预测模型的重要一步。
Zotero 插件