Wang Shan, Meng Meng, Zhang Xue, Wu Chen, Wang Ru, Wu Jiangfen, Sami Muhammad Umair, Xu Kai
School of Medical Imaging, Xuzhou Medical University, Xuzhou, Jiangsu 221004, P.R. China.
Department of Radiology, Jiangsu Jiangyin People's Hospital, Jiangyin, Jiangsu 214400, P.R. China.
Oncol Lett. 2018 May;15(5):7297-7304. doi: 10.3892/ol.2018.8232. Epub 2018 Mar 12.
The present study aimed to explore the role of texture analysis with apparent diffusion coefficient (ADC) maps based on different regions of interest (ROI) in determining glioma grade. Thirty patients with glioma underwent diffusion-weighted imaging (DWI). ADC values were determined from the following three ROIs: i) whole tumor; ii) solid portion; and iii) peritumoral edema. Texture features were compared between high-grade gliomas (HGGs) and low-grade gliomas (LGGs) using the non-parametric Wilcoxon rank-sum test or the unpaired Student's t-test. Receiver operating characteristic (ROC) curves were constructed to determine the optimum threshold for inhomogeneity values in discrimination of HGGs from LGGs. With a spearman rank correlation model, the aforementioned ADC inhomogeneity values were correlated with the Ki-67 labeling index. With whole tumor ROI, inhomogeneity values proved to be significantly different between HGGs and LGGs (P<0.001). With solid portion ROI, inhomogeneity and median values showed significant difference between HGGs and LGGs (P=0.001 and P=0.043, respectively). With peritumoral edema ROI, entropy and edema volume demonstrated positive results (P=0.016, P<0.001). The whole tumor inhomogeneity parameter performed with better diagnostic accuracy (P=0.048) than selecting the solid portion ROI. The association between inhomogeneity and Ki-67 labeling index was significantly positive in whole tumor and solid portion ROI (R=0.628, P<0.001 and R=0.470, P=0.009). Texture analysis of DWI based on different ROI can provide various significant parameters to evaluate tumor heterogeneity, which were correlated with tumor grade. Particularly, the inhomogeneity value derived from whole tumor ROI provided high diagnostic value and predicting the status of tumor proliferation.
本研究旨在探讨基于不同感兴趣区域（ROI）的表观扩散系数（ADC）图纹理分析在确定胶质瘤分级中的作用。30例胶质瘤患者接受了扩散加权成像（DWI）。从以下三个ROI确定ADC值：i）整个肿瘤；ii）实性部分；iii）瘤周水肿。使用非参数Wilcoxon秩和检验或不成对学生t检验比较高级别胶质瘤（HGG）和低级别胶质瘤（LGG）之间的纹理特征。构建受试者操作特征（ROC）曲线以确定区分HGG和LGG的不均匀性值的最佳阈值。使用Spearman秩相关模型，将上述ADC不均匀性值与Ki-67标记指数相关联。对于整个肿瘤ROI，HGG和LGG之间的不均匀性值被证明有显著差异（P<0.001）。对于实性部分ROI，HGG和LGG之间的不均匀性和中位数显示出显著差异（分别为P=0.001和P=0.043）。对于瘤周水肿ROI，熵和水肿体积显示出阳性结果（P=0.016，P<0.001）。整个肿瘤不均匀性参数的诊断准确性（P=0.048）优于选择实性部分ROI。在整个肿瘤和实性部分ROI中，不均匀性与Ki-67标记指数之间的关联显著为正（R=0.628，P<0.001和R=0.470，P=0.009）。基于不同ROI的DWI纹理分析可以提供各种重要参数来评估肿瘤异质性，这些参数与肿瘤分级相关。特别是，从整个肿瘤ROI得出的不均匀性值具有较高的诊断价值，并可预测肿瘤增殖状态。
