Department of Radiology, Ospedale Civile Maggiore - Azienda Ospedaliera Universitaria Integrata Verona, Piazzale A. Stefani 1, 37126, Verona, Italy.
Department of Radiology, Ospedale G.B. Rossi - University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
Abdom Radiol (NY). 2020 Nov;45(11):3809-3818. doi: 10.1007/s00261-020-02509-3.
To evaluate MR-derived histogram parameters in predicting aggressiveness and surgical outcomes in patients with PDAC, by correlating them to pathological features, recurrence-free survival (RFS), and overall survival (OS).
Pre-operative MR examinations of 103 patients with PDAC between July 2014 and September 2018 were retrospectively analyzed. Morphologic features and whole-tumor histogram-derived parameters were correlated to pathological features using Fisher's exact or Mann-Whitney U tests and receiver operating characteristic (ROC) curves were constructed for significant parameters. Cox regression analysis and Kaplan-Meier curves were used to determine the association of clinical-pathological variables, morphological features, and histogram-derived parameters with RFS and OS.
T1, ADC, T2, and ADC had the highest area under the curve (AUC) for prediction of vascular infiltration, nodal metastases, microscopic vascular invasion, and peripancreatic fat invasion (.657, .742, .760, and .818, respectively). Poor tumor differentiation (P = 0.002, hazard ratio-HR = 4.08), nodal ratio (P = 0.034, HR 6.95), and ADC (P = 0.021, HR 1.01) were significant predictors of RFS. Poor tumor differentiation (P = 0.05, HR 2.82), ADC (P = 0.02, HR 3.32), and arterial (P = 0.02, HR 6.84) were the only significant predictors of death; patients with higher arterial had significantly shorter OS than patients who did not meet this criterion (P = 0.02; median OS 24 vs 31 months).
Histogram-derived parameters may predict adverse pathological features in PDACs. High arterial seems to be associated with short OS after surgery in patients with PDAC.
通过与病理特征、无复发生存（RFS）和总生存（OS）相关联，评估 MRI 衍生直方图参数在预测 PDAC 患者侵袭性和手术结果中的作用。
回顾性分析了 2014 年 7 月至 2018 年 9 月间 103 例 PDAC 患者的术前 MRI 检查。使用 Fisher 确切检验或 Mann-Whitney U 检验将形态学特征和全肿瘤直方图衍生参数与病理特征相关联，并构建显著参数的受试者工作特征（ROC）曲线。使用 Cox 回归分析和 Kaplan-Meier 曲线来确定临床病理变量、形态学特征和直方图衍生参数与 RFS 和 OS 的关联。
T1、ADC、T2 和 ADC 对预测血管浸润、淋巴结转移、微血管侵犯和胰周脂肪侵犯的曲线下面积（AUC）最高（分别为 0.657、0.742、0.760 和 0.818）。肿瘤分化不良（P=0.002，危险比-HR=4.08）、淋巴结比值（P=0.034，HR 6.95）和 ADC（P=0.021，HR 1.01）是 RFS 的显著预测因素。肿瘤分化不良（P=0.05，HR 2.82）、ADC（P=0.02，HR 3.32）和动脉（P=0.02，HR 6.84）是唯一的死亡显著预测因素；与未达到这一标准的患者相比，动脉较高的患者 OS 显著缩短（P=0.02；中位 OS 24 与 31 个月）。
直方图衍生参数可能预测 PDAC 的不良病理特征。在 PDAC 患者中，高动脉似乎与手术后的短 OS 相关。
