Department of Radiation Oncology, Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India, 400012.
Department of Biostatistics Tata Memorial Centre, Homi Bhaba National Institute, Mumbai, India, 400012.
Br J Radiol. 2020 May 1;93(1109):20190857. doi: 10.1259/bjr.20190857. Epub 2020 Feb 26.
To study if pre-treatment CT texture features in locally advanced squamous cell carcinoma of laryngo-pharynx can predict long-term local control and laryngectomy free survival (LFS).
Image texture features of 60 patients treated with chemoradiation (CTRT) within an ethically approved study were studied on contrast-enhanced images using a texture analysis research software (TexRad, UK). A filtration-histogram technique was used where the filtration step extracted and enhanced features of different sizes and intensity variations corresponding to a particular spatial scale filter (SSF): SSF = 0 (without filtration), SSF = 2 mm (fine texture), SSF = 3-5 mm (medium texture) and SSF = 6 mm (coarse texture). Quantification by statistical and histogram technique comprised mean intensity, standard-deviation, entropy, mean positive pixels, skewness and kurtosis. The ability of texture analysis to predict LFS or local control was determined using Kaplan-Meier analysis and multivariate cox model.
Median follow-up of patients was 24 months (95% CI:20-28). 39 (65%) patients were locally controlled at last follow-up. 10 (16%) had undergone salvage laryngectomy after CTRT. For both local control & LFS, threshold optimal cut-off values of texture features were analyzed. Medium filtered-texture feature that were associated with poorer laryngectomy free survival were entropy ≥4.54, ( = 0.006), kurtosis ≥4.18; = 0.019, skewness ≤-0.59, = 0.001, and standard deviation ≥43.18; = 0.009). Inferior local control was associated with medium filtered features entropy ≥4.54; p 0.01 and skewness ≤ - 0.12; = 0.02. Using fine filters, entropy ≥4.29 and kurtosis ≥-0.27 were also associated with inferior local control ( = 0.01 for both parameters). Multivariate analysis showed medium filter entropy as an independent predictor for LFS and local control ( < 0.001 & = 0.001).
Medium texture entropy is a predictor for inferior local control and laryngectomy free survival in locally advanced laryngo-pharyngeal cancer and this can complement clinico-radiological factors in predicting prognosticating these tumors.
Texture features play an important role as a surrogate imaging biomarker for predicting local control and laryngectomy free survival in locally advanced laryngo-pharyngeal tumors treated with definitive chemoradiation.
研究局部晚期喉咽鳞状细胞癌患者治疗前 CT 纹理特征是否可以预测长期局部控制和喉切除术无生存（LFS）。
在伦理批准的研究中，对 60 名接受放化疗（CTRT）治疗的患者的图像纹理特征进行了研究，使用纹理分析研究软件（TexRad，英国）在对比增强图像上进行研究。采用滤波-直方图技术，滤波步骤提取并增强了与特定空间尺度滤波器（SSF）相对应的不同大小和强度变化的特征：SSF = 0（无滤波）、SSF = 2mm（细纹理）、SSF = 3-5mm（中纹理）和 SSF = 6mm（粗纹理）。统计和直方图技术的定量包括平均强度、标准偏差、熵、阳性像素均值、偏度和峰度。使用 Kaplan-Meier 分析和多变量 Cox 模型确定纹理分析预测 LFS 或局部控制的能力。
患者中位随访时间为 24 个月（95%CI：20-28）。最后一次随访时，39 名（65%）患者局部控制。10 名（16%）患者在 CTRT 后接受了挽救性喉切除术。对于局部控制和 LFS，分析了纹理特征的最佳截断值。与更好的无喉切除术生存率相关的中等过滤纹理特征是熵≥4.54（ = 0.006）、峰度≥4.18（ = 0.019）、偏度≤-0.59（ = 0.001）和标准差≥43.18（ = 0.009）。较差的局部控制与中等过滤特征熵≥4.54 相关（ < 0.01）和偏度≤-0.12（ = 0.02）。使用细滤波器，熵≥4.29 和峰度≥-0.27 也与较差的局部控制相关（两个参数均为 < 0.01）。多变量分析显示，中等过滤器熵是 LFS 和局部控制的独立预测因子（ < 0.001 和 = 0.001）。
在局部晚期喉咽癌中，中等纹理熵是局部控制和无喉切除术生存率的预测因子，这可以补充临床和放射学因素，预测这些肿瘤的预后。
纹理特征作为替代成像生物标志物，在预测接受确定性放化疗的局部晚期喉咽肿瘤的局部控制和无喉切除术生存率方面具有重要作用。
