Rodrigues Anna, Loman Kelly, Nawrocki Jeff, Hoang Jenny K, Chang Zheng, Mowery Yvonne M, Oyekunle Taofik, Niedzwiecki Donna, Brizel David M, Craciunescu Oana
Department of Radiation Oncology, Duke University Medical Center, Durham, NC, United States.
Department of Radiology, Johns Hopkins University, Baltimore, MD, United States.
Front Oncol. 2021 Sep 2;11:708398. doi: 10.3389/fonc.2021.708398. eCollection 2021.
The purpose of this study was to assess baseline variability in histogram and texture features derived from apparent diffusion coefficient (ADC) maps from diffusion-weighted MRI (DW-MRI) examinations and to identify early treatment-induced changes to these features in patients with head and neck squamous cell carcinoma (HNSCC) undergoing definitive chemoradiation. Patients with American Joint Committee on Cancer Stage III-IV (7 edition) HNSCC were prospectively enrolled on an IRB-approved study to undergo two pre-treatment baseline DW-MRI examinations, performed 1 week apart, and a third early intra-treatment DW-MRI examination during the second week of chemoradiation. Forty texture and six histogram features were derived from ADC maps. Repeatability of the features from the baseline ADC maps was assessed with the intra-class correlation coefficient (ICC). A Wilcoxon signed-rank test compared average baseline and early treatment feature changes. Data from nine patients were used for this study. Comparison of the two baseline ADC maps yielded 11 features with an ICC ≥ 0.80, indicating that these features had excellent repeatability: Run Gray-Level Non-Uniformity, Coarseness, Long Zone High Gray-Level, Variance (Histogram Feature), Cluster Shade, Long Zone, Variance (Texture Feature), Run Length Non-Uniformity, Correlation, Cluster Tendency, and ADC Median. The Wilcoxon signed-rank test resulted in four features with significantly different early treatment-induced changes compared to the baseline values: Run Gray-Level Non-Uniformity (p = 0.005), Run Length Non-Uniformity (p = 0.005), Coarseness (p = 0.006), and Variance (Histogram) (p = 0.006). The feasibility of histogram and texture analysis as a potential biomarker is dependent on the baseline variability of each metric, which disqualifies many features.
本研究的目的是评估从扩散加权磁共振成像（DW-MRI）检查的表观扩散系数（ADC）图中得出的直方图和纹理特征的基线变异性，并确定接受根治性放化疗的头颈部鳞状细胞癌（HNSCC）患者这些特征的早期治疗诱导变化。美国癌症联合委员会第7版III-IV期HNSCC患者被前瞻性纳入一项经机构审查委员会批准的研究，接受两次治疗前基线DW-MRI检查（间隔1周进行），以及在放化疗第二周进行的第三次早期治疗期间DW-MRI检查。从ADC图中得出40个纹理特征和6个直方图特征。使用组内相关系数（ICC）评估基线ADC图中特征的可重复性。采用Wilcoxon符号秩检验比较平均基线和早期治疗特征变化。本研究使用了9名患者的数据。比较两张基线ADC图得出11个ICC≥0.80的特征，表明这些特征具有出色的可重复性：游程灰度非均匀性、粗糙度、长区域高灰度、方差（直方图特征）、聚类阴影、长区域、方差（纹理特征）、游程长度非均匀性、相关性、聚类倾向和ADC中位数。Wilcoxon符号秩检验结果显示，与基线值相比，有4个特征的早期治疗诱导变化有显著差异：游程灰度非均匀性（p = 0.005）、游程长度非均匀性（p = 0.005）、粗糙度（p = 0.006）和方差（直方图）（p = 0.006）。直方图和纹理分析作为一种潜在生物标志物的可行性取决于每个指标的基线变异性，这使得许多特征不合格。
