Doi Shuhei, Yanagawa Masahiro, Matsui Takahiro, Hata Akinori, Kikuchi Noriko, Yoshida Yuriko, Yamagata Kazuki, Ninomiya Keisuke, Kido Shoji, Tomiyama Noriyuki
Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City 565-0871, Osaka, Japan.
Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City 565-0871, Osaka, Japan.
J Clin Med. 2023 Aug 28;12(17):5610. doi: 10.3390/jcm12175610.
: Dual-energy CT has been reported to be useful for differentiating thymic epithelial tumors. The purpose is to evaluate thymic epithelial tumors by using three-dimensional (3D) iodine density histogram texture analysis on dual-energy CT and to investigate the association of extracellular volume fraction (ECV) with the fibrosis of thymic carcinoma. : 42 patients with low-risk thymoma ( = 20), high-risk thymoma ( = 16), and thymic carcinoma ( = 6) were scanned by dual-energy CT. 3D iodine density histogram texture analysis was performed for each nodule on iodine density mapping: Seven texture features (max, min, median, average, standard deviation [SD], skewness, and kurtosis) were obtained. The iodine effect (average on DECT180s-average on unenhanced DECT) and ECV on DECT180s were measured. Tissue fibrosis was subjectively rated by one pathologist on a three-point grade. These quantitative data obtained by examining associations with thymic carcinoma and high-risk thymoma were analyzed with univariate and multivariate logistic regression models (LRMs). The area under the curve (AUC) was calculated by the receiver operating characteristic curves. values < 0.05 were significant. : The multivariate LRM showed that ECV > 21.47% in DECT180s could predict thymic carcinoma (odds ratio [OR], 11.4; 95% confidence interval [CI], 1.18-109; = 0.035). Diagnostic performance was as follows: Sensitivity, 83.3%; specificity, 69.4%; AUC, 0.76. In high-risk thymoma vs. low-risk thymoma, the multivariate LRM showed that the iodine effect ≤1.31 mg/cc could predict high-risk thymoma (OR, 7; 95% CI, 1.02-39.1; = 0.027). Diagnostic performance was as follows: Sensitivity, 87.5%; specificity, 50%; AUC, 0.69. Tissue fibrosis significantly correlated with thymic carcinoma ( = 0.026). : ECV on DECT180s related to fibrosis may predict thymic carcinoma from thymic epithelial tumors, and the iodine effect on DECT180s may predict high-risk thymoma from thymoma.
据报道，双能量CT有助于鉴别胸腺上皮肿瘤。目的是利用双能量CT的三维（3D）碘密度直方图纹理分析评估胸腺上皮肿瘤，并研究细胞外体积分数（ECV）与胸腺癌纤维化的相关性。42例低危胸腺瘤（n = 20）、高危胸腺瘤（n = 16）和胸腺癌（n = 6）患者接受了双能量CT扫描。对碘密度图上的每个结节进行3D碘密度直方图纹理分析：获得七个纹理特征（最大值、最小值、中位数、平均值、标准差[SD]、偏度和峰度）。测量碘效应（DECT180s上的平均值减去未增强DECT上的平均值）和DECT180s上的ECV。由一名病理学家对组织纤维化进行主观的三分制评分。通过单变量和多变量逻辑回归模型（LRM）分析这些与胸腺癌和高危胸腺瘤相关性的定量数据。通过受试者工作特征曲线计算曲线下面积（AUC）。P值<0.05具有显著性。多变量LRM显示，DECT180s上ECV>21.47%可预测胸腺癌（优势比[OR]，11.4；95%置信区间[CI]，1.18 - 109；P = 0.035）。诊断性能如下：敏感性，83.3%；特异性，69.4%；AUC，0.76。在高危胸腺瘤与低危胸腺瘤的比较中，多变量LRM显示碘效应≤1.31 mg/cc可预测高危胸腺瘤（OR，7；95% CI，1.02 - 39.1；P = 0.027）。诊断性能如下：敏感性，87.5%；特异性，50%；AUC，0.69。组织纤维化与胸腺癌显著相关（P = 0.026）。DECT180s上与纤维化相关的ECV可能有助于从胸腺上皮肿瘤中预测胸腺癌，而DECT180s上的碘效应可能有助于从胸腺瘤中预测高危胸腺瘤。
