Department of Medical Ultrasounics, East division of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Medical Ultrasonics, Ultrasonics Artificial Intelligence X-Lab, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Diagn Interv Radiol. 2021 May;27(3):424-431. doi: 10.5152/dir.2021.20031.
We aimed to explore the diagnostic efficiency of shear-wave elastography (SWE) ultrasomics in the preoperative prediction of lymph node (LN) metastasis in rectal cancer.
This study included 87 patients with pathologically confirmed rectal cancer, with data gathered from August 2017 to August 2018. A total of 1044 ultrasomics features of rectal tumor were collected with AK software from the SWE examinations. The least absolute shrinkage and selection operator (LASSO) regression model was used for feature selection and building a SWE ultrasomics signature. The diagnostic performance was evaluated with an area under the receiver operating characteristic curve (AUC) analysis. Then, the diagnostic performance of the SWE ultrasomics signature was compared with magnetic resonance imaging (MRI).
Of the 87 patients, 40 (46.0%) had LN metastasis. Thirteen ultrasomics features of rectal tumor were selected as the most significant features. The SWE ultrasomics signature correlated with LN metastasis (p < 0.001). Patients with LN metastasis had higher signature than patients without LN metastasis. In terms of diagnostic performance, SWE ultrasomics signature was significantly superior to MRI (AUC, 0.883 vs. 0.760, p = 0.034). The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE ultrasomics signature were 82.8%, 87.5%, 78.8%, 77.8%, and 88.1%, respectively, while those of MRI were 75.9%, 77.5%, 74.5%, 72.1%, and 79.6%, respectively.
SWE ultrasomics is a more accurate predictive method for identifying LN metastasis preoperatively than MRI. Thus, SWE ultrasomics might be used to better guide preoperative individual therapies for patients with rectal cancer.
本研究旨在探讨剪切波弹性超声（SWE）在术前预测直肠癌淋巴结（LN）转移中的诊断效率。
本研究纳入了 2017 年 8 月至 2018 年 8 月期间经病理证实的 87 例直肠癌患者。共采集 1044 例直肠肿瘤的 SWE 检查 AK 软件的超声特征。采用最小绝对收缩和选择算子（LASSO）回归模型进行特征选择和构建 SWE 超声特征签名。采用受试者工作特征曲线（ROC）下面积（AUC）分析评估诊断性能。然后，将 SWE 超声特征签名的诊断性能与磁共振成像（MRI）进行比较。
87 例患者中，40 例（46.0%）存在 LN 转移。13 个直肠肿瘤超声特征被选为最重要的特征。SWE 超声特征签名与 LN 转移相关（p<0.001）。存在 LN 转移的患者特征签名值高于无 LN 转移的患者。在诊断性能方面，SWE 超声特征签名明显优于 MRI（AUC：0.883 比 0.760，p=0.034）。SWE 超声特征签名的诊断准确性、敏感度、特异度、阳性预测值（PPV）和阴性预测值（NPV）分别为 82.8%、87.5%、78.8%、77.8%和 88.1%，而 MRI 的分别为 75.9%、77.5%、74.5%、72.1%和 79.6%。
SWE 超声在术前识别 LN 转移方面比 MRI 更准确，因此 SWE 超声可能用于更好地指导直肠癌患者的术前个体化治疗。
