肾透明细胞癌瘤周肾周脂肪分析。
Juxtatumoral perinephric fat analysis in clear cell renal cell carcinoma.
机构信息
Keck School of Medicine, University of Southern California, Radiology, Los Angeles, CA, 90033, USA.
Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Pathology, Los Angeles, CA, USA.
出版信息
Abdom Radiol (NY). 2019 Apr;44(4):1470-1480. doi: 10.1007/s00261-018-1848-x.
PURPOSE
The purpose of the study was to evaluate the feasibility of using contrast-enhanced computed tomography (CECT)-based texture analysis (CTTA) metrics to differentiate between juxtatumoral perinephric fat (JPF) surrounding low-grade (ISUP 1-2) versus high-grade (ISUP 3-4) clear cell renal cell carcinoma (ccRCC).
METHODS
In this IRB-approved study, we retrospectively queried the surgical database between June 2009 and April 2016 and identified 83 patients with pathologically confirmed ccRCC (low grade: n = 54, mean age = 61.5 years, 18F/35M; high grade n = 30, mean age = 61.7 years, 8F/22M) who also had pre-operative multiphase CT acquisitions. CT images were transferred to a 3D workstation, and nephrographic phase JPF regions were manually segmented. Using an in-house developed Matlab program, a CTTA panel comprising of texture metrics extracted using six different methods, histogram, 2D- and 3D-Gray-level co-occurrence matrix (GLCM) and Gray-level difference matrix (GLDM), and 2D-Fast Fourier Transform (FFT) analyses, was applied to the segmented images to assess JPF textural heterogeneity in low- versus high-grade ccRCC. Univariate analysis and receiver-operator characteristics (ROC) analysis were used to assess interclass differences in texture metrics and their prediction accuracy, respectively.
RESULTS
All methods except GLCM consistently revealed increased heterogeneity in the JPF surrounding high- versus low-grade ccRCC. FFT showed increased complexity index (p < 0.01). Histogram analysis showed increased kurtosis and positive skewness in (p < 0.03), and GLDM analysis showed decreased measure of correlation coefficient (MCC) (p < 0.04). Several of the GLCM metrics showed statistically significant (p < 0.04) textural differences between the two groups, but with no consistent trend. ROC analysis showed that MCC in GLCM analysis had an area under the curve of 0.75.
CONCLUSIONS
Our study suggests that CTTA of ccRCC shows statistically significant textural differences in JPF surrounding high- versus low-grade ccRCC.
目的
本研究旨在评估基于对比增强计算机断层扫描（CECT）的纹理分析（CTTA）指标区分低级别（ISUP 1-2）和高级别（ISUP 3-4）透明细胞肾细胞癌（ccRCC）瘤周肾周脂肪（JPF）的可行性。
方法
在这项经机构审查委员会批准的研究中，我们回顾性地查询了 2009 年 6 月至 2016 年 4 月的手术数据库，并确定了 83 例经病理证实的 ccRCC 患者（低级别：n=54，平均年龄 61.5 岁，男 18 例，女 36 例；高级别：n=30，平均年龄 61.7 岁，男 8 例，女 22 例），这些患者术前均行多期 CT 扫描。将 CT 图像传输到 3D 工作站，并手动分割肾图期 JPF 区域。使用内部开发的 Matlab 程序，对分割后的图像应用包含六种不同方法（直方图、二维和三维灰度共生矩阵[GLCM]和灰度差分矩阵[GLDM]、二维快速傅里叶变换[FFT]分析）提取的 CTTA 面板，以评估低级别和高级别 ccRCC 瘤周 JPF 的纹理异质性。采用单变量分析和受试者工作特征（ROC）分析分别评估纹理指标的组间差异及其预测准确性。
结果
除 GLCM 外，所有方法均显示高级别 ccRCC 瘤周 JPF 的异质性增加。FFT 显示复杂性指数增加（p<0.01）。直方图分析显示峰度和正偏度增加（p<0.03），GLDM 分析显示相关系数度量（MCC）降低（p<0.04）。GLCM 分析中多项 GLCM 指标显示两组间存在统计学显著的（p<0.04）纹理差异，但无一致趋势。ROC 分析显示 GLCM 分析中的 MCC 曲线下面积为 0.75。
结论
本研究表明，ccRCC 的 CTTA 显示高级别和低级别 ccRCC 瘤周 JPF 存在统计学显著的纹理差异。
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