Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA, United States of America.
Phys Med Biol. 2018 Nov 7;63(21):215027. doi: 10.1088/1361-6560/aae7f1.
Based on 4D-CT, we aimed to characterize the pattern of morphological changes in lung tumors during respiration, and investigated its potential in non-invasively differentiating lung adenocarcinoma (AC) and squamous cell carcinoma (SCC). We applied a 3D surface analysis on 22 tumors (13 AC, 9 SCC) to investigate the tumor regional morphological fluctuations in response to respiration phases. Tumor surface vertices among ten respiratory phases were matched using surface-based registration, and the shape descriptors (ρ and detJ) were calculated and tracked across respiration stages in a regionally aligned scenario. Pair-wise group comparisons were performed between lung AC and SCC subtypes, in terms of ratios of maximal shape changes as well as correlation coefficients between tumor shape and respiratory stage indicators from the lung. AC type tumors had averaged larger surface measurements at exhale than at inhale, and these surface measurements were negatively correlated with lung volumes across respiratory stages. In contrast, SCC type tumors had averaged smaller surface measurements at exhale than at inhale, and the correlations with lung volumes were positive. The group differences in maximal shape changes as well as correlations were both statistically significant (p < 0.05). We developed a non-invasive lung tumor sub-type detection pipeline based on respiration-induced tumor surface deformation. Significant differences in deformation patterns were detected between lung AC and SCC. The derived surface measurements may potentially serve as a new non-invasive imaging biomarker of lung cancer subtypes.
基于 4D-CT，我们旨在描述肺部肿瘤在呼吸过程中形态变化的模式，并研究其在无创区分肺腺癌（AC）和鳞状细胞癌（SCC）方面的潜力。我们对 22 个肿瘤（13 个 AC，9 个 SCC）应用了 3D 表面分析，以研究肿瘤区域形态对呼吸相的波动反应。使用基于表面的配准匹配十个呼吸相之间的肿瘤表面顶点，并在区域对齐的情况下计算和跟踪区域内呼吸阶段的形状描述符（ρ 和 detJ）。在肺腺癌和 SCC 亚型之间，根据最大形状变化比以及肿瘤形状与肺呼吸阶段指标之间的相关系数，进行了成对组比较。AC 型肿瘤在呼气时的表面测量值平均大于吸气时，并且这些表面测量值与呼吸阶段的肺体积呈负相关。相比之下，SCC 型肿瘤在呼气时的表面测量值平均小于吸气时，与肺体积的相关性为正。最大形状变化和相关性的组间差异均具有统计学意义（p < 0.05）。我们开发了一种基于呼吸诱导的肿瘤表面变形的无创肺肿瘤亚型检测管道。在肺 AC 和 SCC 之间检测到变形模式的显著差异。所得的表面测量值可能潜在地作为肺癌亚型的新的无创成像生物标志物。
