Wang R, Yang X Y, Wang K Y, Wang S, Li Q, Wu J F, Xu H T, Dai Y, Han C P, Xu K, Chen G H
Department of radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China.
Ge Pharmaceutical (Shanghai) Co., Ltd, Shanghai 201203, China.
Zhonghua Gan Zang Bing Za Zhi. 2017 Mar 20;25(3):200-204. doi: 10.3760/cma.j.issn.1007-3418.2017.03.008.
To investigate the feasibility of contrast-enhanced computer tomography (CT) texture analysis in predicting early recurrence after transarterial chemoembolization (TACE) in patients with liver cancer. A retrospective analysis was performed for 47 patients with liver cancer confirmed by liver biopsy and digital subtraction angiography who underwent upper abdominal contrast-enhanced CT scan before TACE, and according to the presence or absence of focal recurrence within half a year, these patients were divided into early recurrence (ER) group and non-early recurrence (NER) group. The texture analysis was used to delineate tumor boundary layer by layer on the axial contrast-enhanced CT image before liver cancer surgery, and related parameters of tumor heterogeneity, including entropy, mean, non-uniformity, skewness, and kurtosis, were obtained. The independent samples t-test was used for comparison of texture parameters between the two groups. The receiver operating characteristic (ROC) curve was used for the analysis of entropy, mean, and non-uniformity, and the area under the ROC curve (ROC), optical cut-off value, sensitivity, and specificity were calculated to evaluate the efficiency of texture analysis in predicting early focal recurrence after TACE. There were 20 patients in the ER group and 27 in the NER group. The ER group had a maximum major axis length of 88.2±36.3 mm and a maximum minor axis length of 41.4±21.4 mm, and the NER group had a maximum major axis length of 66.9±30.2 mm and a maximum minor axis length of 29.3±19.8 mm; the ER group had significantly higher maximum major and minor axis lengths than the NER group ( = 4.89 and 4.62, < 0.001). The ER group had significantly higher entropy and non-uniformity values than the NER group, and there were no significant differences in skewness and kurtosis between the two groups. Entropy, non-uniformity, and mean had high efficiency in predicting early recurrence after TACE, and the optimal cut-off value of entropy was 4.135. Volumetric texture analysis of contrast-enhanced CT images before liver cancer surgery has a high value in predicting early recurrence after TACE.
探讨对比增强计算机断层扫描(CT)纹理分析在预测肝癌患者经动脉化疗栓塞术(TACE)后早期复发中的可行性。对47例经肝活检和数字减影血管造影确诊为肝癌且在TACE术前接受上腹部对比增强CT扫描的患者进行回顾性分析,根据半年内是否存在局灶性复发,将这些患者分为早期复发(ER)组和非早期复发(NER)组。采用纹理分析在肝癌手术前的轴位对比增强CT图像上逐层勾勒肿瘤边界,获取肿瘤异质性的相关参数,包括熵、均值、不均匀性、偏度和峰度。采用独立样本t检验比较两组纹理参数。采用受试者操作特征(ROC)曲线分析熵、均值和不均匀性,并计算ROC曲线下面积(ROC)、最佳截断值、敏感度和特异度,以评估纹理分析预测TACE后早期局灶性复发的效能。ER组20例,NER组27例。ER组最大长轴长度为88.2±36.3mm,最大短轴长度为41.4±21.4mm,NER组最大长轴长度为66.9±30.2mm,最大短轴长度为29.3±19.8mm;ER组最大长轴和短轴长度显著高于NER组(t值分别为4.89和4.62,P<0.001)。ER组熵和不均匀性值显著高于NER组,两组偏度和峰度无显著差异。熵、不均匀性和均值在预测TACE后早期复发方面具有较高效能,熵的最佳截断值为4.135。肝癌手术前对比增强CT图像的容积纹理分析在预测TACE后早期复发方面具有较高价值。