Department of Radiology, Fudan University Shanghai Cancer Center, No. 270 Dongan Rd., Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Abdom Radiol (NY). 2019 Jan;44(1):65-71. doi: 10.1007/s00261-018-1682-1.
The purpose of the study was to determine whether the pre-treated MR texture features of colorectal liver metastases (CRLMs) are predictive of therapeutic response after chemotherapy.
The study included twenty-six consecutive patients (a total of 193 liver metastasis) with unrespectable CRLMs at our institution from August 2014 to February 2016. Lesions were categorized into either responding group or non-responding group according to changes in size. Texture analysis was quantified on T2-weighted images by two radiologists with consensus on regions of interest which were manually drawn on the largest cross-sectional area of the lesions. Five histogram features (mean, variance, skewness, kurtosis, and entropy) and five gray level co-occurrence matrix features (GLCM; angular second moment (ASM), entropy, contrast, correlation, and inverse difference moment (IDM)) were extracted. The texture parameters were statistically analyzed to identify the differences between the two groups, and the potential predictive parameters to differentiate the responding group from the non-responding group were subsequently tested using multivariable logistic regression analysis.
A total of 107 responding and 86 non-responding lesions were evaluated. A higher variance, entropy, contrast, entropy and a lower ASM, correlation, IDM were independently (P < 0.05) associated with a good response to chemotherapy with the areas under the ROC curves (AUCs) of 0.602-0.784. Variance (P < 0.001) and ASM (P = 0.001) remained potential predictive values to discriminate responding lesions from non-responding lesions when tested using multivariable logistic regression analysis. The highest AUC of the predictors from the association of variance and ASM was 0.814.
MR texture features on pre-treated T2 images have the potential to predict the therapeutic response of colorectal liver metastases.
本研究旨在确定结直肠癌肝转移（CRLM）经化疗预处理后的 MR 纹理特征是否与化疗后的治疗反应相关。
本研究纳入了 2014 年 8 月至 2016 年 2 月期间在我院就诊的 26 例不可切除 CRLM 患者（共 193 个肝转移病灶）。根据病灶大小的变化，将病灶分为反应组和非反应组。两名放射科医生对 T2 加权图像进行了纹理分析，通过手动在病灶最大横截面积上绘制感兴趣区来进行定量分析。提取了 5 个直方图特征（均值、方差、偏度、峰度和熵）和 5 个灰度共生矩阵特征（GLCM；角二阶矩（ASM）、熵、对比度、相关性和逆差矩（IDM））。对纹理参数进行统计学分析，以识别两组之间的差异，然后使用多变量逻辑回归分析来检验潜在的预测参数，以区分反应组和非反应组。
共评估了 107 个反应性病变和 86 个非反应性病变。较高的方差、熵、对比度、熵和较低的 ASM、相关性、IDM 与化疗的良好反应独立相关（P<0.05），ROC 曲线下面积（AUC）为 0.602-0.784。方差（P<0.001）和 ASM（P=0.001）在多变量逻辑回归分析中仍然是预测反应性病变与非反应性病变的潜在预测值。方差和 ASM 联合预测因子的 AUC 最高为 0.814。
预处理 T2 图像上的 MR 纹理特征有可能预测结直肠癌肝转移的治疗反应。
