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ADC 纹理分析在预测接受同期放化疗的 2018 FIGO ⅡICr 期宫颈癌患者生存中的附加价值。

Added-value of texture analysis of ADC in predicting the survival of patients with 2018 FIGO stage IIICr cervical cancer treated by concurrent chemoradiotherapy.

机构信息

Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.

GE Healthcare, MR Research, Beijing, China.

出版信息

Eur J Radiol. 2022 May;150:110272. doi: 10.1016/j.ejrad.2022.110272. Epub 2022 Mar 21.

DOI:10.1016/j.ejrad.2022.110272

PMID:35334244

Abstract

PURPOSE

To investigate the value of texture analysis of ADC in predicting the survival of patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IIICr cervical squamous cell cancer (CSCC) treated with concurrent chemoradiotherapy (CCRT).

METHODS

A total of 91 patients with stage IIICr CSCC treated by CCRT between January 2014 and December 2018 were retrospectivelyenrolled in this study. Clinical variables and 21 first-order texture features extracted from ADC maps were collected. Univariate and multivariate Cox hazard regression analyses were performed to evaluate these parameters in predicting progression-free survival (PFS) and overall survival (OS). The independent variables were combined to build a prediction model and compared with the 2018 FIGO staging system. Survival curves were generated using the Kaplan-Meier method, and the log-rank test was used for comparison.

RESULTS

Mean Absolute Deviation (MAD), T stage, and the number of lymph node metastasis (LNM) were independently associated with PFS, while MAD, energy, T stage, number of LNM, and tumor grade were independently associated with OS. The C-index values of the combined models for PFS and OS, which were respectively 0.750 and 0.832, were significantly higher compared to 2018 FIGO staging system values of 0.629 and 0.630, respectively (P < 0.05).

CONCLUSIONS

The texture analysis of the ADC maps could be used along with clinical prognostic biomarkers to predict PFS and OS in patients with stage IIICr CSCC treated by CCRT.

摘要

目的

探讨 ADC 纹理分析在预测接受同期放化疗（CCRT）的 2018 年国际妇产科联合会（FIGO）分期 IIICr 宫颈鳞状细胞癌（CSCC）患者生存中的价值。

方法

回顾性分析 2014 年 1 月至 2018 年 12 月期间接受 CCRT 的 91 例 IIICr CSCC 患者的临床资料，收集患者的临床变量和 ADC 图上提取的 21 个一阶纹理特征。采用单因素和多因素 Cox 风险回归分析评估这些参数在预测无进展生存期（PFS）和总生存期（OS）中的作用。将独立变量进行组合以构建预测模型，并与 2018 年 FIGO 分期系统进行比较。采用 Kaplan-Meier 法生成生存曲线，并采用对数秩检验进行比较。

结果

平均绝对偏差（MAD）、T 分期和淋巴结转移（LNM）数量与 PFS 独立相关，而 MAD、能量、T 分期、LNM 数量和肿瘤分级与 OS 独立相关。PFS 和 OS 联合模型的 C 指数值分别为 0.750 和 0.832，明显高于 2018 年 FIGO 分期系统的 0.629 和 0.630（P<0.05）。