Cancer Imaging最新文献_第7页

IF 4.9 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-17 DOI: 10.1186/s40644-024-00774-9

Giulia Santo, Maria Cucè, Antonino Restuccia, Teresa Del Giudice, Pierfrancesco Tassone, Francesco Cicone, Pierosandro Tagliaferri, Giuseppe Lucio Cascini

Direct comparisons between [18F]FDG PET/CT findings and clinical occurrence of immune-related adverse events (irAEs) based on independent assessments of clinical and imaging features in patients receiving immune checkpoint inhibitors (ICIs) are missing. Our aim was to estimate sites, frequency, and timing of immune-related PET findings during ICIs treatment in patients with melanoma and NSCLC, and to assess their correlation with clinical irAEs. Prognostic implications of immune-related events were also investigated. Fifty-one patients with melanoma (47%) or NSCLC (53%) undergoing multiple PET examinations during anti-PD1/PDL1 treatment were retrospectively included. Clinical irAEs were graded according to CTCAE v.5.0. Abnormal PET findings suggestive of immune activation were described by two readers blinded to the clinical data. Progression-free survival (PFS) and overall survival (OS) were analyzed with the Kaplan-Meier method in patients stratified according to the presence of irAEs, immune-related PET findings or both. Twenty-one patients showed clinical irAEs only (n = 6), immune-related PET findings only (n = 6), or both (n = 9). In patients whose imaging findings corresponded to clinical irAEs (n = 7), a positive correlation between SUVmax and the severity of the clinical event was observed (rs=0.763, p = 0.046). Clinical irAEs occurred more frequently in patients without macroscopic disease than in metastatic patients (55% vs. 23%, p = 0.039). Patients who developed clinical irAEs had a significantly longer PFS than patients who remained clinically asymptomatic, both in the overall cohort (p = 0.011) and in the subgroup of (n = 35) patients with metastatic disease (p = 0.019). The occurrence of immune-related PET findings significantly stratified PFS in the overall cohort (p = 0.040), and slightly missed statistical significance in patients with metastatic disease (p = 0.08). The best stratification of PFS was achieved when all patients who developed immune-related events, either clinically relevant or detected by PET only, were grouped together both in the overall cohort (p = 0.002) and in patients with metastatic disease (p = 0.004). In the whole sample, OS was longer in patients who developed any immune-related events (p = 0.032). Patients with melanoma or NSCLC under ICI treatment can develop clinical irAEs, immune-related PET findings, or both. The occurrence of immune-related events has a prognostic impact. Combining clinical information with PET assessment improved outcome stratification.

在接受免疫检查点抑制剂（ICIs）治疗的患者中，目前还没有基于临床和影像学特征独立评估的[18F]FDG PET/CT检查结果与免疫相关不良事件（irAEs）临床发生率之间的直接比较。我们的目的是估计黑色素瘤和 NSCLC 患者在 ICIs 治疗期间出现免疫相关 PET 发现的部位、频率和时间，并评估它们与临床 irAEs 的相关性。研究还探讨了免疫相关事件的预后影响。回顾性纳入了51名在抗PD1/PDL1治疗期间接受多次PET检查的黑色素瘤（47%）或NSCLC（53%）患者。临床 irAE 根据 CTCAE v.5.0 进行分级。提示免疫激活的 PET 异常发现由两名对临床数据保密的阅读者进行描述。采用卡普兰-梅耶法（Kaplan-Meier method）分析了根据虹膜AEs、免疫相关PET结果或两者的存在对患者进行分层的无进展生存期（PFS）和总生存期（OS）。21例患者仅出现临床虹膜异常（6例）、仅出现免疫相关PET结果（6例）或两者均有（9例）。在成像结果与临床虹膜急性缺失相一致的患者中（n = 7），观察到 SUVmax 与临床事件的严重程度呈正相关（rs=0.763，p = 0.046）。与转移性患者相比，无大体病变的患者发生临床虹膜AE的频率更高（55% vs. 23%，p = 0.039）。无论是在总体队列（p = 0.011）中，还是在转移性疾病患者亚组（n = 35）（p = 0.019）中，出现临床虹膜异常的患者的PFS明显长于临床无症状的患者。免疫相关PET检查结果的出现对总体队列的PFS分层有显著影响（p = 0.040），对转移性疾病患者的分层略微缺乏统计学意义（p = 0.08）。如果将所有发生免疫相关事件（无论是临床相关事件还是仅通过 PET 检测到的事件）的患者归为一组，则可对总体队列（p = 0.002）和转移性疾病患者（p = 0.004）的 PFS 进行最佳分层。在整个样本中，发生任何免疫相关事件的患者的OS更长（p = 0.032）。接受 ICI 治疗的黑色素瘤或 NSCLC 患者可能出现临床免疫相关事件、免疫相关 PET 发现或两者兼而有之。免疫相关事件的发生对预后有影响。将临床信息与 PET 评估相结合可改善预后分层。

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引用次数: 0

Radiomics predicts the prognosis of patients with clear cell renal cell carcinoma by reflecting the tumor heterogeneity and microenvironment 放射组学通过反映肿瘤异质性和微环境预测透明细胞肾细胞癌患者的预后

IF 4.9 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-16 DOI: 10.1186/s40644-024-00768-7

Ji Wu, Jian Li, Bo Huang, Sunbin Dong, Luyang Wu, Xiping Shen, Zhigang Zheng

We aimed to develop and externally validate a CT-based deep learning radiomics model for predicting overall survival (OS) in clear cell renal cell carcinoma (ccRCC) patients, and investigate the association of radiomics with tumor heterogeneity and microenvironment. The clinicopathological data and contrast-enhanced CT images of 512 ccRCC patients from three institutions were collected. A total of 3566 deep learning radiomics features were extracted from 3D regions of interest. We generated the deep learning radiomics score (DLRS), and validated this score using an external cohort from TCIA. Patients were divided into high and low-score groups by the DLRS. Sequencing data from the corresponding TCGA cohort were used to reveal the differences of tumor heterogeneity and microenvironment between different radiomics score groups. What’s more, univariate and multivariate Cox regression were used to identify independent risk factors of poor OS after operation. A combined model was developed by incorporating the DLRS and clinicopathological features. The SHapley Additive exPlanation method was used for interpretation of predictive results. At multivariate Cox regression analysis, the DLRS was identified as an independent risk factor of poor OS. The genomic landscape of different radiomics score groups was investigated. The heterogeneity of tumor cell and tumor microenvironment significantly varied between both groups. In the test cohort, the combined model had a great predictive performance, with AUCs (95%CI) for 1, 3 and 5-year OS of 0.879(0.868–0.931), 0.854(0.819–0.899) and 0.831(0.813–0.868), respectively. There was a significant difference in survival time between different groups stratified by the combined model. This model showed great discrimination and calibration, outperforming the existing prognostic models (all p values < 0.05). The combined model allowed for the prognostic prediction of ccRCC patients by incorporating the DLRS and significant clinicopathologic features. The radiomics features could reflect the tumor heterogeneity and microenvironment.

我们的目的是开发并从外部验证一种基于CT的深度学习放射组学模型，用于预测透明细胞肾细胞癌（ccRCC）患者的总生存期（OS），并研究放射组学与肿瘤异质性和微环境的关联。研究收集了来自三家机构的512名ccRCC患者的临床病理数据和对比增强CT图像。从三维感兴趣区共提取了3566个深度学习放射组学特征。我们生成了深度学习放射组学评分（DLRS），并使用 TCIA 的外部队列验证了该评分。根据 DLRS 将患者分为高分组和低分组。相应的TCGA队列中的测序数据用于揭示不同放射组学评分组间肿瘤异质性和微环境的差异。此外，研究人员还利用单变量和多变量Cox回归来确定术后OS不良的独立风险因素。结合 DLRS 和临床病理特征，建立了一个综合模型。预测结果的解释采用了SHapley Additive exPlanation方法。在多变量Cox回归分析中，DLRS被确定为不良OS的独立风险因素。研究还调查了不同放射组学评分组的基因组状况。肿瘤细胞和肿瘤微环境的异质性在两组之间存在显著差异。在测试队列中，组合模型具有很好的预测性能，1年、3年和5年OS的AUC（95%CI）分别为0.879（0.868-0.931）、0.854（0.819-0.899）和0.831（0.813-0.868）。根据综合模型进行分层后，不同组间的生存时间存在明显差异。该模型具有很高的区分度和校准性，优于现有的预后模型（所有 p 值均小于 0.05）。综合模型结合了 DLRS 和重要的临床病理特征，可以对 ccRCC 患者进行预后预测。放射组学特征可以反映肿瘤的异质性和微环境。

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引用次数: 0

Effects of tube voltage, radiation dose and adaptive statistical iterative reconstruction strength level on the detection and characterization of pulmonary nodules in ultra-low-dose chest CT 管电压、辐射剂量和自适应统计迭代重建强度水平对超低剂量胸部 CT 中肺部结节检测和定性的影响

IF 4.9 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-15 DOI: 10.1186/s40644-024-00770-z

Yue Yao, Xuan Su, Lei Deng, JingBin Zhang, Zengmiao Xu, Jianying Li, Xiaohui Li

To explore the effects of tube voltage, radiation dose and adaptive statistical iterative reconstruction (ASiR-V) strength level on the detection and characterization of pulmonary nodules by an artificial intelligence (AI) software in ultra-low-dose chest CT (ULDCT). An anthropomorphic thorax phantom containing 12 spherical simulated nodules (Diameter: 12 mm, 10 mm, 8 mm, 5 mm; CT value: -800HU, -630HU, 100HU) was scanned with three ULDCT protocols: Dose-1 (70kVp:0.11mSv, 100kVp:0.10mSv), Dose-2 (70kVp:0.34mSv, 100kVp:0.32mSv), Dose-3 (70kVp:0.53mSv, 100kVp:0.51mSv). All scanning protocols were repeated five times. CT images were reconstructed using four different strength levels of ASiR-V (0%=FBP, 30%, 50%, 70%ASiR-V) with a slice thickness of 1.25 mm. The characteristics of the physical nodules were used as reference standards. All images were analyzed using a commercially available AI software to identify nodules for calculating nodule detection rate (DR) and to obtain their long diameter and short diameter, which were used to calculate the deformation coefficient (DC) and size measurement deviation percentage (SP) of nodules. DR, DC and SP of different imaging groups were statistically compared. Image noise decreased with the increase of ASiR-V strength level, and the 70 kV images had lower noise under the same strength level (mean-value 70 kV: 40.14 ± 7.05 (dose 1), 27.55 ± 7.38 (dose 2), 23.88 ± 6.98 (dose 3); 100 kV: 42.36 ± 7.62 (dose 1); 30.78 ± 6.87 (dose 2); 26.49 ± 6.61 (dose 3)). Under the same dose level, there were no differences in DR between 70 kV and 100 kV (dose 1: 58.76% vs. 58.33%; dose 2: 73.33% vs. 70.83%; dose 3: 75.42% vs. 75.42%, all p > 0.05). The DR of GGNs increased significantly at dose 2 and higher (70 kV: 38.12% (dose 1), 60.63% (dose 2), 64.38% (dose 3); 100 kV: 37.50% (dose 1), 59.38% (dose 2), 66.25% (dose 3)). In general, the use of ASiR-V at higher strength levels (> 50%) and 100 kV provided better (lower) DC and SP. Detection rates are similar between 70 kV and 100 kV scans. The 70 kV images have better noise performance under the same ASiR-V level, while images of 100 kV and higher ASiR-V levels are better in preserving the nodule morphology (lower DC and SP); the dose levels above 0.33mSv provide high sensitivity for nodules detection, especially the simulated ground glass nodules.

探讨超低剂量胸部 CT（ULDCT）中管电压、辐射剂量和自适应统计迭代重建（ASiR-V）强度水平对人工智能（AI）软件检测和表征肺结节的影响。用三种超低剂量胸部 CT 方案扫描了一个拟人胸部模型，该模型包含 12 个球形模拟结节（直径：12 毫米、10 毫米、8 毫米、5 毫米；CT 值：-800HU、-630HU、100HU）：剂量-1（70kVp:0.11mSv，100kVp:0.10mSv）、剂量-2（70kVp:0.34mSv，100kVp:0.32mSv）、剂量-3（70kVp:0.53mSv，100kVp:0.51mSv）。所有扫描方案均重复五次。使用四种不同强度的 ASiR-V （0%=FBP、30%、50%、70%ASiR-V）重建 CT 图像，切片厚度为 1.25 毫米。物理结节的特征被用作参考标准。使用市售人工智能软件对所有图像进行分析，识别结节以计算结节检出率（DR），并获得结节的长径和短径，用于计算结节的变形系数（DC）和尺寸测量偏差百分比（SP）。对不同成像组的 DR、DC 和 SP 进行统计比较。图像噪声随 ASiR-V 强度的增加而降低，在相同强度下，70 kV 图像的噪声较低（平均值 70 kV：40.14 ± 7.05（剂量 1），27.55 ± 7.38（剂量 2），23.88 ± 6.98（剂量 3）；100 kV：42.36 ± 7.62（剂量 1），30.78 ± 6.87（剂量 2），26.49 ± 6.61（剂量 3））。在相同剂量水平下，70 千伏和 100 千伏之间的 DR 没有差异（剂量 1：58.76% vs. 58.33%；剂量 2：73.33% vs. 70.83%；剂量 3：75.42% vs. 75.42%，均 p > 0.05）。剂量 2 及以上时，GGN 的 DR 显著增加（70 kV：38.12%（剂量 1），60.63%（剂量 2），64.38%（剂量 3）；100 kV：37.50%（剂量 1），59.38%（剂量 2），66.25%（剂量 3））。一般来说，在较高强度水平（> 50%）和 100 kV 下使用 ASiR-V 可提供更好（更低）的直流和 SP。70 千伏和 100 千伏扫描的检测率相似。在相同的 ASiR-V 水平下，70 kV 图像的噪声性能更好，而 100 kV 和更高 ASiR-V 水平的图像在保留结节形态方面更好（DC 和 SP 更低）；0.33mSv 以上的剂量水平可提供高灵敏度的结节检测，尤其是模拟磨玻璃结节。

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引用次数: 0

Prediction of axillary lymph node metastasis using a magnetic resonance imaging radiomics model of invasive breast cancer primary tumor 利用侵袭性乳腺癌原发肿瘤的磁共振成像放射组学模型预测腋窝淋巴结转移

IF 4.9 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-13 DOI: 10.1186/s40644-024-00771-y

Wei Shi, Yingshi Su, Rui Zhang, Wei Xia, Zhenqiang Lian, Ning Mao, Yanyu Wang, Anqin Zhang, Xin Gao, Yan Zhang

This study investigated the clinical value of breast magnetic resonance imaging (MRI) radiomics for predicting axillary lymph node metastasis (ALNM) and to compare the discriminative abilities of different combinations of MRI sequences. This study included 141 patients diagnosed with invasive breast cancer from two centers (center 1: n = 101, center 2: n = 40). Patients from center 1 were randomly divided into training set and test set 1. Patients from center 2 were assigned to the test set 2. All participants underwent preoperative MRI, and four distinct MRI sequences were obtained. The volume of interest (VOI) of the breast tumor was delineated on the dynamic contrast-enhanced (DCE) postcontrast phase 2 sequence, and the VOIs of other sequences were adjusted when required. Subsequently, radiomics features were extracted from the VOIs using an open-source package. Both single- and multisequence radiomics models were constructed using the logistic regression method in the training set. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and precision of the radiomics model for the test set 1 and test set 2 were calculated. Finally, the diagnostic performance of each model was compared with the diagnostic level of junior and senior radiologists. The single-sequence ALNM classifier derived from DCE postcontrast phase 1 had the best performance for both test set 1 (AUC = 0.891) and test set 2 (AUC = 0.619). The best-performing multisequence ALNM classifiers for both test set 1 (AUC = 0.910) and test set 2 (AUC = 0.717) were generated from DCE postcontrast phase 1, T2-weighted imaging, and diffusion-weighted imaging single-sequence ALNM classifiers. Both had a higher diagnostic level than the junior and senior radiologists. The combination of DCE postcontrast phase 1, T2-weighted imaging, and diffusion-weighted imaging radiomics features had the best performance in predicting ALNM from breast cancer. Our study presents a well-performing and noninvasive tool for ALNM prediction in patients with breast cancer.

本研究探讨了乳腺磁共振成像（MRI）放射组学在预测腋窝淋巴结转移（ALNM）方面的临床价值，并比较了不同磁共振成像序列组合的判别能力。这项研究包括来自两个中心（中心1：n = 101，中心2：n = 40）的141名确诊为浸润性乳腺癌的患者。中心 1 的患者被随机分为训练集和测试集 1。中心 2 的患者被分配到测试集 2。所有参与者都接受了术前核磁共振成像检查，并获得了四个不同的核磁共振成像序列。乳腺肿瘤的感兴趣容积（VOI）在动态对比增强（DCE）后对比第二阶段序列上划定，其他序列的感兴趣容积在需要时进行调整。随后，使用一个开源软件包从 VOIs 中提取放射组学特征。在训练集中使用逻辑回归法构建了单序列和多序列放射组学模型。计算了辐射组学模型在测试集 1 和测试集 2 中的接收者操作特征曲线下面积（AUC）、准确性、灵敏度、特异性和精确度。最后，将每个模型的诊断性能与初级和高级放射科医生的诊断水平进行了比较。在测试集 1（AUC = 0.891）和测试集 2（AUC = 0.619）中，从 DCE 后对比阶段 1 得出的单序列 ALNM 分类器表现最佳。在测试集 1（AUC = 0.910）和测试集 2（AUC = 0.717）中表现最佳的多序列 ALNM 分类器是由 DCE 对比后一期、T2 加权成像和扩散加权成像单序列 ALNM 分类器生成的。两者的诊断水平均高于初级和高级放射科医生。DCE对比后一期、T2加权成像和弥散加权成像放射组学特征组合在预测乳腺癌ALNM方面表现最佳。我们的研究为乳腺癌患者的 ALNM 预测提供了一种性能良好的无创工具。

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引用次数: 0

Proceedings of ICIS SGCR-WIRES 2024, held jointly with the 23rd International Cancer Imaging Society Annual Conference, collaborating with the Singapore Radiological Society and College of Radiologists Singapore ICIS SGCR-WIRES 2024 年会议论文集》，与第 23 届国际癌症成像学会年会联合举办，新加坡放射学会和新加坡放射学院协办

IF 4.9 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-12 DOI: 10.1186/s40644-024-00751-2

<h3>O1 A randomized controlled trial of preoperative prostate artery embolization before transurethral resection of prostate glands larger than 80cc</h3><h4>Zong Yi Chin1, Alvin YM Lee2, Neo Shu Hui3, Ng Tze Kiat2, Edwin Jonathan Aslim2, Allen SP Sim4, Pradesh Kumar5, John SP Yuen2, Kenneth Chen2, Sivanathan Chandramohan1</h4><h5>1Vascular and Interventional Radiology, Singapore General Hospital, Singapore; 2Urology, Singapore General Hospital, Singapore; 3Urology, Sengkang General Hospital, Singapore; 4Urology, Gleneagles Medini Johor, Malaysia; 5Radiology, Sunway Medical Centre, Malaysia</h5>Cancer Imaging (2024), 24 (1): O1 Objectives/ Teaching Points:To study the impact of preoperative prostate artery embolization (PAE) on intraoperative blood loss during transurethral resection of the prostate (TURP) for large prostates (exceeding 80 cc).Material(s) and Method(s):A prospective, surgeon-blinded, randomized controlled trial was performed at a single tertiary centre. Patients with prostate volumes over 80 cc who needed TURP were randomly allocated (1:1) to receive preoperative prostatic artery embolization followed by TURP (Group A—intervention) or TURP alone (Group B—control). The primary outcome measured the postoperative drop in haemoglobin levels, as a surrogate for blood loss. Secondary outcomes studied included resection efficiency (weight of resected tissue per minute) and the rate of postoperative complications.Results:There were 10 patients in each group. The median prostate volumes were 119 mL for Group A and 140 mL for Group B, with median preoperative haemoglobin levels of 13.3 g/dL (IQR 12.5–14.3 g/dL) in Group A and 14.4 g/dL (IQR 10.1–15.2 g/dL) in Group B. The decrease in postoperative haemoglobin was significantly greater in Group B compared to Group A (-1.4 g/dL vs + 0.5 g/dL, p = 0.015). There were no significant differences between the groups in terms of the weight of resected prostate tissue (52 g vs 73 g, p = 0.089) and resection efficiency (0.7 g/min vs 0.6 g/min, p = 0.853). Two patients in Group B needed a red blood cell transfusion, compared to one patient in Group A (p = 1.000). One patient from each group required an additional surgery for haemostasis.Conclusions:Preoperative PAE significantly decreased TURP blood loss in men with large prostates.<h3>O2 Improving AI Transparency Using an Uncertainty-inspired Classification Model for Chest Xray Diagnosis</h3><h4>Shu Wen Goh1, Yangqin Feng2, Xinxing Xu2, Yong Liu2, Cher Heng Tan1</h4><h5>1Diagnostic Radiology, Tan Tock Seng Hospital, Singapore; 2Institute of High-Performance Computing, A*STAR, Singapore</h5>

经常使用的模板包括测量结果，但结论条件各不相同。P23 光子计数探测器 CT 在心血管成像中的应用Mon Ben Chow, Jeffrey Seow Kuang Goh, Peter Yu-Tang Goh, Robert Khoon Kwok新加坡百汇放射科癌症成像（2024），24 (1)：P23目的/教学要点：心血管疾病是全球死亡的主要原因。CT 成像是一种重要工具，可为控制这些疾病提供关键信息。该技术的最新进展是光子计数探测器（PCD）CT。与传统的能量积分探测器（EID）CT 相比，它具有明显的改进。本海报将重点介绍 PCD CT 与 EID CT 的区别，研究 PCD CT 的技术细节和术语，提供方案指导，并通过病例展示临床应用。P24 胆囊癌的各种表现形式及其模拟物Salwa Al Sarahani、Mei Chin Lim新加坡国立大学医院诊断成像部癌症成像（2024），24 (1)：P24胆囊癌是胆道系统最常见的癌症。不幸的是，胆囊癌是一种侵袭性肿瘤，通常发病较晚，预后较差。胆囊癌的诊断具有挑战性，因为患者通常没有症状或出现非特异性体征和症状，这些体征和症状可能与其他良性疾病（如慢性胆囊炎（包括黄疽性胆囊炎）、胆固醇息肉、腺肌瘤病）以及其他恶性肿瘤（如淋巴瘤、转移瘤或原发性肝癌的直接侵犯）相似。此外，胆囊癌的危险因素（如胆石症）也与其他良性胆囊疾病重叠。早期肿瘤通常是在影像学检查或因其他原因进行胆囊切除术时偶然发现的。局部疾病的典型影像学特征包括胆囊壁不对称的局灶性或弥漫性增厚、大于 1.0 厘米的息肉或取代胆囊腔的实性肿块。晚期肿瘤通常具有浸润性，并伴有邻近器官的侵犯和结节转移，甚至可能出现腹膜病变。我们旨在通过横断面成像展示不同病期的胆囊癌病例及其模拟病例，提供有助于提示胆囊癌诊断的成像珍珠。P25 用于子宫内膜癌风险分层的多参数磁共振成像放射组学模型Jiarui Zhang1, Rahul Singh1, Cheuk Nam Hwang1, Philip Ip2, Ka Yu Tse3, Elaine Yuen Phin Lee11香港大学放射诊断学系；2Department of Pathology, University of Hong Kong, Hong Kong; 3epartment of Obstetrics and Gynaecology, University of Hong Kong, Hong KongCancer Imaging (2024),24 (1)：P25目的/教学要点：子宫内膜癌（EC）的风险分层决定了是否需要进行辅助治疗。我们旨在建立 MRI 放射组学模型，用于 EC 的术前风险分层。材料和方法：本回顾性研究收集了 2018 年 11 月至 2023 年 7 月 238 例病理确诊 EC 患者的 MRI 数据。排除了核磁共振成像不完整、有明显伪影和核磁共振成像无可见肿瘤的患者。根据ESGO/ESTRO/ESP的建议，使用标准组织病理学因素对患者进行风险分层。使用PyRadiomics软件包（3.1版）从表观弥散系数（ADC）图（b = 0,400,800 s/mm2）、T2加权成像（T2WI）和动态对比增强（DCE）MRI中提取放射组学特征。所有患者按 85:15 的分层比例分为训练组和测试组。利用矛曼相关性剔除了高度相关（90%）的特征，并采用基于等级的特征选择方法（即 Boruta，以 XGBoost 作为估计器）选出了最重要的特征。采用 ADASYN（自适应合成）来缓解类不平衡问题。在开发该框架时，采用了剪枝和超参数调整梯度提升分类器以及十倍分层交叉验证（SCV）。结果：162 名符合条件的患者被分为 3 个风险组，低风险组 77 人，中风险组 35 人，高风险组 50 人。在多参数放射组学模型中选取了7个特征（4个来自ADC图，2个来自T2WI，1个来自DCE-MRI）。选出的最佳模型在测试集中达到了以下性能指标：曲线下面积（0.801）、灵敏度（0.778）、特异度（0.870）和准确度（0.760）。

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引用次数: 0

The utility of 18F-FDG PET/CT for predicting the pathological response and prognosis to neoadjuvant immunochemotherapy in resectable non-small-cell lung cancer 18F-FDG PET/CT 对可切除非小细胞肺癌新辅助免疫化疗病理反应和预后的预测作用

IF 4.9 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-10 DOI: 10.1186/s40644-024-00772-x

Rui Guo, Wanpu Yan, Fei Wang, Hua Su, Xiangxi Meng, Qing Xie, Wei Zhao, Zhi Yang, Nan Li

To evaluate the potential utility of 18F-FDG PET/CT to assess response to neoadjuvant immunochemotherapy in patients with resectable NSCLC, and the ability to screen patients who may benefit from neoadjuvant immunochemotherapy. Fifty one resectable NSCLC (stage IA–IIIB) patients were analyzed, who received two-three cycles neoadjuvant immunochemotherapy.18F-FDG PET/CT was carried out at baseline(scan-1) and prior to radical resection(scan-2). SULmax, SULpeak, MTV, TLG, T/N ratio, ΔSULmax%,ΔSULpeak%, ΔMTV%, ΔTLG%,ΔT/N ratio% were calculated. 18F-FDG PET/CT responses were classified using PERCIST. We then compared the RECIST 1.1 and PERCIST criteria for response assessment.With surgical pathology of primary lesions as the gold standard, the correlation between metabolic parameters of 18F-FDG PET/CT and major pathologic response (MPR) was analyzed. All metabolic parameters were compared to treatment response and correlated to PFS and OS. In total of fifty one patients, MPR was achieved in 25(49%, 25/51) patients after neoadjuvant therapy. The metabolic parameters of Scan-1 were not correlated with MPR.The degree of pathological regression was negatively correlated with SULmax, SULpeak, MTV, TLG, T/N ratio of scan-2, and the percentage changes of the ΔSULmax%, ΔSULpeak%, ΔMTV%,ΔTLG%,ΔT/N ratio% after neoadjuvant therapy (p < 0.05). According to PERCIST, 36 patients (70.6%, 36/51) showed PMR, 12 patients(23.5%, 12/51) had stable metabolic disease(SMD), and 3 patients(5.9%, 3/51) had progressive metabolic disease (PMD). ROC indicated that all of scan-2 metabolic parameters and the percentage changes of metabolic parameters had ability to predict MPR and non-MPR, SULmax and T/N ratio of scan-2 had the best differentiation ability.The accuracy of RECIST 1.1 and PERCIST criteria were no statistical significance(p = 0.91). On univariate analysis, ΔMTV% has the highest correlation with PFS. Metabolic response by 18F-FDG PET/CT can predict MPR to neoadjuvant immunochemotherapy in resectable NSCLC. ΔMTV% was significantly correlated with PFS.

评估18F-FDG PET/CT在评估可切除NSCLC患者对新辅助免疫化疗反应方面的潜在作用，以及筛选可能从新辅助免疫化疗中获益的患者的能力。研究分析了51例可切除NSCLC（IA-IIIB期）患者，这些患者接受了2-3个周期的新辅助免疫化疗。18F-FDG PET/CT在基线（扫描-1）和根治性切除术前（扫描-2）进行。计算SULmax、SULpeak、MTV、TLG、T/N比值、ΔSULmax%、ΔSULpeak%、ΔMTV%、ΔTLG%、ΔT/N比值。使用 PERCIST 对 18F-FDG PET/CT 反应进行分类。然后，我们比较了 RECIST 1.1 和 PERCIST 的反应评估标准。以原发病灶的手术病理为金标准，分析了 18F-FDG PET/CT 代谢参数与主要病理反应（MPR）之间的相关性。所有代谢参数都与治疗反应进行了比较，并与PFS和OS相关。在51例患者中，25例（49%，25/51）患者在新辅助治疗后达到了MPR。病理消退程度与扫描-2的SULmax、SULpeak、MTV、TLG、T/N比值以及新辅助治疗后ΔSULmax%、ΔSULpeak%、ΔMTV%、ΔTLG%、ΔT/N比值%的百分比变化呈负相关（P＜0.05）。根据 PERCIST，36 例患者（70.6%，36/51）表现为 PMR，12 例患者（23.5%，12/51）为稳定代谢病（SMD），3 例患者（5.9%，3/51）为进展代谢病（PMD）。ROC表明，扫描-2的所有代谢参数和代谢参数的百分比变化都具有预测MPR和非MPR的能力，扫描-2的SULmax和T/N比值具有最好的分辨能力，RECIST 1.1和PERCIST标准的准确性无统计学意义（P = 0.91）。在单变量分析中，ΔMTV%与PFS的相关性最高。18F-FDG PET/CT 代谢反应可预测可切除 NSCLC 新辅助免疫化疗的 MPR。ΔMTV%与PFS有明显相关性。

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引用次数: 0

Radiomics of multi-parametric MRI for the prediction of lung metastasis in soft-tissue sarcoma: a feasibility study. 用于预测软组织肉瘤肺转移的多参数磁共振成像放射组学：一项可行性研究。

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-05 DOI: 10.1186/s40644-024-00766-9

Yue Hu, Xiaoyu Wang, Zhibin Yue, Hongbo Wang, Yan Wang, Yahong Luo, Wenyan Jiang

Purpose: To investigate the value of multi-parametric MRI-based radiomics for preoperative prediction of lung metastases from soft tissue sarcoma (STS).

Methods: In total, 122 patients with clinicopathologically confirmed STS who underwent pretreatment T1-weighted contrast-enhanced (T1-CE) and T2-weighted fat-suppressed (T2FS) MRI scans were enrolled between Jul. 2017 and Mar. 2021. Radiomics signatures were established by calculating and selecting radiomics features from the two sequences. Clinical independent predictors were evaluated by statistical analysis. The radiomics nomogram was constructed from margin and radiomics features by multivariable logistic regression. Finally, the study used receiver operating characteristic (ROC) and calibration curves to evaluate performance of radiomics models. Decision curve analyses (DCA) were performed to evaluate clinical usefulness of the models.

Results: The margin was considered as an independent predictor (p < 0.05). A total of 4 MRI features were selected and used to develop the radiomics signature. By incorporating the margin and radiomics signature, the developed nomogram showed the best prediction performance in the training (AUCs, margin vs. radiomics signature vs. nomogram, 0.609 vs. 0.909 vs. 0.910) and validation (AUCs, margin vs. radiomics signature vs. nomogram, 0.666 vs. 0.841 vs. 0.894) cohorts. DCA indicated potential usefulness of the nomogram model.

Conclusions: This feasibility study evaluated predictive values of multi-parametric MRI for the prediction of lung metastasis, and proposed a nomogram model to potentially facilitate the individualized treatment decision-making for STSs.

目的：研究基于多参数磁共振成像的放射组学在软组织肉瘤（STS）肺转移术前预测中的价值：2017年7月至2021年3月期间，共有122例临床病理确诊的STS患者接受了预处理T1加权对比增强（T1-CE）和T2加权脂肪抑制（T2FS）MRI扫描。通过计算和选择两个序列的放射组学特征，建立放射组学特征。通过统计分析评估了临床独立预测因子。通过多变量逻辑回归，根据边缘和放射组学特征构建了放射组学提名图。最后，研究使用接收者操作特征曲线（ROC）和校准曲线来评估放射组学模型的性能。研究还进行了决策曲线分析（DCA），以评估模型的临床实用性：结果：边际被认为是一个独立的预测因子（p 结论：放射组学模型的临床实用性很高：这项可行性研究评估了多参数磁共振成像在预测肺转移方面的预测价值，并提出了一种提名图模型，有望促进 STS 的个体化治疗决策。

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引用次数: 0

Optimization and validation of echo times of point-resolved spectroscopy for cystathionine detection in gliomas. 优化和验证点分辨光谱法检测胶质瘤中胱硫醚的回波时间。

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-09-02 DOI: 10.1186/s40644-024-00764-x

Min Zhou, Zhuang Nie, Jie Zhao, Yao Xiao, Xiaohua Hong, Yuhui Wang, Chengjun Dong, Alexander P Lin, Ziqiao Lei

Background: Cystathionine accumulates selectively in 1p/19q-codeleted gliomas, and can serve as a possible noninvasive biomarker. This study aims to optimize the echo time (TE) of point-resolved spectroscopy (PRESS) for cystathionine detection in gliomas, and evaluate the diagnostic accuracy of PRESS for 1p/19q-codeletion identification.

Methods: The TE of PRESS was optimized with numerical and phantom analysis to better resolve cystathionine from the overlapping aspartate multiplets. The optimized and 97 ms TE PRESS were then applied to 84 prospectively enrolled patients suspected of glioma or glioma recurrence to examine the influence of aspartate on cystathionine quantification by fitting the spectra with and without aspartate. The diagnostic performance of PRESS for 1p/19q-codeleted gliomas were assessed.

Results: The TE of PRESS was optimized as (TE1, TE2) = (17 ms, 28 ms). The spectral pattern of cystathionine and aspartate were consistent between calculation and phantom. The mean concentrations of cystathionine in vivo fitting without aspartate were significantly higher than those fitting with full basis-set for 97 ms TE PRESS (1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM, p < 0.01), but not significantly different for 45 ms method (0.801 ± 1.217 mM and 0.796 ± 1.217 mM, p = 0.494). The cystathionine concentrations of 45 ms approach was better correlated with those of edited MRS than 97 ms counterparts (r = 0.68 vs. 0.49, both p < 0.01). The sensitivity and specificity for discriminating 1p/19q-codeleted gliomas were 66.7% and 73.7% for 45 ms method, and 44.4% and 52.5% for 97 ms method, respectively.

Conclusion: The 45 ms TE PRESS yields more precise cystathionine estimates than the 97 ms method, and is anticipated to facilitate noninvasive diagnosis of 1p/19q-codeleted gliomas, and treatment response monitoring in those patients. Medium diagnostic performance of PRESS for 1p/19q-codeleted gliomas were observed, and warrants further investigations.

背景：胱硫醚会在1p/19q编码缺失的胶质瘤中选择性蓄积，可作为一种可能的无创生物标记物。本研究旨在优化点分辨光谱法（PRESS）检测胶质瘤中胱硫醚的回波时间（TE），并评估PRESS对1p/19q编码缺失识别的诊断准确性：通过数值分析和模型分析对 PRESS 的 TE 进行了优化，以更好地从重叠的天冬氨酸多信号中分辨出胱硫醚。然后将优化后的和 97 ms TE 的 PRESS 应用于 84 例前瞻性入组的疑似胶质瘤或胶质瘤复发患者，通过拟合含天冬氨酸和不含天冬氨酸的光谱，研究天冬氨酸对胱硫醚定量的影响。评估了 PRESS 对 1p/19q 缺失编码胶质瘤的诊断性能：结果：PRESS 的 TE 优化为 (TE1, TE2) = (17 ms, 28 ms)。胱硫醚和天门冬氨酸的光谱模式在计算和模型中保持一致。在 97 ms TE PRESS 条件下，不含天冬氨酸的体内拟合胱硫醚平均浓度明显高于全基集拟合（1.97 ± 2.01 mM vs. 1.55 ± 1.95 mM，p 结论）：45 毫秒 TE PRESS 比 97 毫秒方法能得出更精确的胱硫醚估计值，预计将有助于对 1p/19q 缺失编码胶质瘤进行无创诊断，并监测这些患者的治疗反应。据观察，PRESS 对 1p/19q 缺失编码胶质瘤的诊断效果中等，值得进一步研究。

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引用次数: 0

Prognostic significance of a negative PSMA PET/CT in biochemical recurrence of prostate cancer. PSMA PET/CT 阴性对前列腺癌生化复发的预后意义。

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-08-30 DOI: 10.1186/s40644-024-00752-1

Sara Harsini, Patrick Martineau, Sonia Plaha, Heather Saprunoff, Catherine Chen, Julia Bishop, Scott Tyldesley, Don Wilson, François Bénard

Background: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is becoming standard of care for men with biochemical recurrence (BCR) of prostate cancer. The implications of a negative PSMA PET/CT scan in this population remain unclear. This study aims to assess the outcome of patients with BCR post radical prostatectomy (RP) who have negative [18F]DCFPyL PET/CT scan at relapse.Methods: This is a post-hoc subgroup analysis of a prospective non randomized clinical trial. One hundred and one patients (median age, 75 years) with BCR after RP, who tested negative on [18F]DCFPyL PET/CT and subsequently either underwent salvage radiotherapy (sRT) with or without androgen deprivation therapy (ADT) or were followed without active treatment, were included. Freedom from progression (FFP) after negative PSMA PET/CT was determined based on follow-up imaging selected as per clinical practice. Uni- and multivariate Cox regression analyses were performed to examine the association of patients' characteristics, tumor-specific variables, and treatment with clinical progression at the last follow-up. FFP at 1-, 2-, and 3-year were reported using Kaplan Meier analysis.Results: The median PSA level at PET/CT was 0.56 ng/mL (range, 0.4-11.3). Sixty five (64%) patients were followed without receiving further treatment, and 36 (36%) received sRT (18% to the prostate bed only and 18% to the prostate bed and pelvic lymph nodes) within 3 months of the PSMA PET. Seventeen of the sRT patients (17 of 36, 47%) received concomitant androgen deprivation therapy (ADT). Median follow-up was 39 months. Subsequent clinical progression was detected in 21 patients (21%), with 52% in pelvic lymph nodes, 52% in the prostatic fossa, 19% in distant lymph nodes, 14% in lungs, and 10% in bones. The FFP was 95% (95% CI: 91%-99%) at 12 months, 87% (95% CI: 81%-94%) at 24 months, and 79% (95% CI: 71%-88%) at 36 months. Multivariate Cox regression analysis revealed that an initial International Society of Urological Pathology (ISUP) grade 5 was significantly associated with clinical progression at the last follow-up (hazard ratio, 5.1, P value, 0.04). Furthermore, the receipt of sRT correlated significantly with lower clinical progression at the last follow-up (hazard ratio, 0.2, P value, 0.03), whereas other clinical and tumor-specific parameters did not. Following surveillance-only and sRT, 29% (19 of 65) and 6% (2 of 36) of patients, respectively, showed clinical progression. In the sRT group, no significant difference was observed in FFP between patients who underwent sRT to the prostatic fossa versus those who received sRT to the prostatic fossa and pelvic lymph nodes, although the numbers in these groups were small.Conclusions: This study suggests that salvage radiotherapy is associated with a decreased or delayed clinical prog

背景：前列腺特异性膜抗原（PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）已成为前列腺癌生化复发（BCR）男性的标准治疗方法。PSMA PET/CT 扫描阴性对这类人群的影响尚不清楚。本研究旨在评估前列腺癌根治术（RP）后复发时[18F]DCFPyL PET/CT扫描阴性的前列腺癌患者的预后：这是一项前瞻性非随机临床试验的事后亚组分析。研究纳入了 111 例 RP 术后 BCR 患者（中位年龄 75 岁），这些患者的[18F]DCFPyL PET/CT 检测结果为阴性，随后接受了带或不带雄激素剥夺疗法（ADT）的挽救性放疗（sRT），或在未接受积极治疗的情况下接受了随访。PSMA PET/CT 阴性后的进展自由度（FFP）是根据临床实践选择的随访成像结果确定的。对患者特征、肿瘤特异性变量和治疗方法与最后一次随访时临床进展的关系进行了单变量和多变量 Cox 回归分析。采用卡普兰-梅耶尔分析法报告了1年、2年和3年的FFP情况：PET/CT检查的PSA水平中位数为0.56纳克/毫升（范围为0.4-11.3）。65名（64%）患者在PSMA PET检查后未接受进一步治疗，36名（36%）患者在PSMA PET检查后3个月内接受了sRT治疗（18%仅对前列腺床进行治疗，18%对前列腺床和盆腔淋巴结进行治疗）。其中 17 名 sRT 患者（36 人中有 17 人，占 47%）同时接受了雄激素剥夺疗法 (ADT)。中位随访时间为 39 个月。21名患者（21%）发现了后续临床进展，其中52%发生在盆腔淋巴结，52%发生在前列腺窝，19%发生在远处淋巴结，14%发生在肺部，10%发生在骨骼。12个月时的FFP为95%（95% CI：91%-99%），24个月时为87%（95% CI：81%-94%），36个月时为79%（95% CI：71%-88%）。多变量考克斯回归分析显示，最初的国际泌尿病理学会（ISUP）5级与最后一次随访时的临床进展显著相关（危险比为5.1，P值为0.04）。此外，接受 sRT 与最后一次随访时较低的临床进展显著相关（危险比为 0.2，P 值为 0.03），而其他临床和肿瘤特异性参数则不相关。接受单纯监测和 sRT 治疗后，分别有 29% （65 例中的 19 例）和 6% （36 例中的 2 例）的患者出现临床进展。在sRT组中，前列腺窝接受sRT的患者与前列腺窝和盆腔淋巴结接受sRT的患者的FFP没有明显差异，尽管这两组的人数很少：本研究表明，对于 PSMA PET/CT 扫描结果为阴性的根治性前列腺切除术后生化复发患者，挽救性放疗与临床进展的减少或延迟有关。分析还强调了初始ISUP分级的预后意义，ISUP 5级与较差的预后相关：注册日期：2016年9月14日；NCT02899312 。

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引用次数: 0

Intravoxel incoherent motion diffusion-weighted imaging in evaluating preoperative staging of esophageal squamous cell carcinoma : Evaluation of preoperative stage of primary tumour and prediction of lymph node metastases from esophageal cancer using IVIM: a prospective study. 利用体内非相干运动弥散加权成像评估食管鳞状细胞癌的术前分期：利用IVIM评估原发肿瘤的术前分期和预测食管癌的淋巴结转移：一项前瞻性研究。

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging

Pub Date : 2024-08-29 DOI: 10.1186/s40644-024-00765-w

Tao Song, Shuang Lu, Jinrong Qu, Hongkai Zhang, Zhaoqi Wang, Zhengyan Jia, Hailiang Li, Yan Zhao, Jianjun Qin, Wen Feng, Shaoyu Wang, Xu Yan

Background: The aim of this research is to prospectively investigate the diagnostic performance of intravoxel incoherent motion (IVIM) using the integrated slice-specific dynamic shimming (iShim) technique in staging primary esophageal squamous cell carcinoma (ESCC) and predicting presence of lymph node metastases from ESCC.

Methods: Sixty-three patients with ESCC were prospectively enrolled from April 2016 to April 2019. MR and IVIM using iShim technique (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm²) were performed on 3.0T MRI system before operation. Primary tumour apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D^*), pseudodiffusion fraction (f) were measured by two independent radiologists. The differences in D, D^*, f and ADC values of different T and N stages were assessed. Intraclass correlation coefficients (ICCs) were calculated to evaluate the interobserver agreement between two readers. The diagnostic performances of D, D^*, f and ADC values in primary tumour staging and prediction of lymph node metastasis of ESCC were determined using receiver operating characteristic (ROC) curve analysis.

Results: The inter-observer consensus was excellent for IVIM parameters and ADC (D: ICC = 0.922; D^*: ICC = 0.892; f: ICC = 0.948; ADC: ICC = 0.958). The ADC, D, D^* and f values of group T1 + T2 were significantly higher than those of group T3 + T4a [ADC: (2.55 ± 0.43) ×10^- 3 mm²/s vs. (2.27 ± 0.40) ×10^- 3 mm²/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10^- 3 mm²/s vs. (1.53 ± 0.33) ×10^- 3 mm²/s, t = 3.189, P = 0.002; D^*: 46.45 (30.30,55.53) ×10^- 3 mm²/s vs. 32.30 (18.60,40.95) ×10^- 3 mm²/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]. The ADC, D and f values of the lymph nodes-positive (N+) group were significantly lower than those of lymph nodes-negative (N0) group [ADC: (2.10 ± 0.33) ×10^- 3 mm²/s vs. (2.55 ± 0.40) ×10^- 3 mm²/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10^- 3 mm²/s vs. (1.78 ± 0.37) ×10^- 3 mm²/s, t=-3.726, P < 0.001; f: 0.32 ± 0.10 vs. 0.45 ± 0.11, t=-4.524, P < 0.001]. The combination of D, D^* and f yielded the highest area under the curve (AUC) (0.814) in distinguishing group T1 + T2 from group T3 + T4a. D combined with f provided the highest diagnostic performance (AUC = 0.849) in identifying group N + and group N0 of ESCC.

Conclusions: IVIM may be used as an effective functional imaging technique to evaluate preoperative stage of primary tumour and predict presence of lymph node metastases from ESCC.

研究背景本研究的目的是前瞻性地调查体外非相干运动（IVIM）在对原发性食管鳞状细胞癌（ESCC）分期和预测ESCC淋巴结转移方面的诊断性能：从2016年4月至2019年4月，63名ESCC患者被纳入前瞻性研究。手术前在 3.0T MRI 系统上使用 iShim 技术（b = 0、25、50、75、100、200、400、600、800 s/mm2）进行 MR 和 IVIM 检查。原发肿瘤表观弥散系数（ADC）和IVIM参数，包括真弥散系数（D）、假弥散系数（D*）和假弥散分数（f）由两名独立的放射科医生测量。评估了不同 T 期和 N 期 D、D*、f 和 ADC 值的差异。通过计算类内相关系数（ICC）来评估两位读者之间的观察者间一致性。使用接收器操作特征曲线（ROC）分析确定了D、D*、f和ADC值在ESCC原发肿瘤分期和淋巴结转移预测中的诊断性能：IVIM参数和ADC的观察者间共识非常好（D：ICC = 0.922；D*：ICC = 0.892；f：ICC = 0.948；ADC：ICC = 0.958）。T1 + T2 组的 ADC、D、D* 和 f 值明显高于 T3 + T4a 组[ADC：（2.55 ± 0.43）×10- 3 mm2/s vs. （2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*：46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]。淋巴结阳性（N+）组的ADC、D和f值明显低于淋巴结阴性（N0）组[ADC：（2.10±0.33）×10- 3 mm2/s vs. （2.55±0.40）×10- 3 mm2/s，t=-4.3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P * 和 f 在区分 T1 + T2 组和 T3 + T4a 组时产生的曲线下面积（AUC）（0.814）最高。D 联合 f 在鉴别 ESCC 的 N + 组和 N0 组方面具有最高的诊断性能（AUC = 0.849）：IVIM可作为一种有效的功能成像技术，用于评估原发肿瘤的术前分期和预测ESCC是否存在淋巴结转移。

{"title":"Intravoxel incoherent motion diffusion-weighted imaging in evaluating preoperative staging of esophageal squamous cell carcinoma : Evaluation of preoperative stage of primary tumour and prediction of lymph node metastases from esophageal cancer using IVIM: a prospective study.","authors":"Tao Song, Shuang Lu, Jinrong Qu, Hongkai Zhang, Zhaoqi Wang, Zhengyan Jia, Hailiang Li, Yan Zhao, Jianjun Qin, Wen Feng, Shaoyu Wang, Xu Yan","doi":"10.1186/s40644-024-00765-w","DOIUrl":"https://doi.org/10.1186/s40644-024-00765-w","url":null,"abstract":"Background: The aim of this research is to prospectively investigate the diagnostic performance of intravoxel incoherent motion (IVIM) using the integrated slice-specific dynamic shimming (iShim) technique in staging primary esophageal squamous cell carcinoma (ESCC) and predicting presence of lymph node metastases from ESCC.Methods: Sixty-three patients with ESCC were prospectively enrolled from April 2016 to April 2019. MR and IVIM using iShim technique (b = 0, 25, 50, 75, 100, 200, 400, 600, 800 s/mm2) were performed on 3.0T MRI system before operation. Primary tumour apparent diffusion coefficient (ADC) and IVIM parameters, including true diffusion coefficient (D), pseudodiffusion coefficient (D*), pseudodiffusion fraction (f) were measured by two independent radiologists. The differences in D, D*, f and ADC values of different T and N stages were assessed. Intraclass correlation coefficients (ICCs) were calculated to evaluate the interobserver agreement between two readers. The diagnostic performances of D, D*, f and ADC values in primary tumour staging and prediction of lymph node metastasis of ESCC were determined using receiver operating characteristic (ROC) curve analysis.Results: The inter-observer consensus was excellent for IVIM parameters and ADC (D: ICC = 0.922; D*: ICC = 0.892; f: ICC = 0.948; ADC: ICC = 0.958). The ADC, D, D* and f values of group T1 + T2 were significantly higher than those of group T3 + T4a [ADC: (2.55 ± 0.43) ×10- 3 mm2/s vs. (2.27 ± 0.40) ×10- 3 mm2/s, t = 2.670, P = 0.010; D: (1.82 ± 0.39) ×10- 3 mm2/s vs. (1.53 ± 0.33) ×10- 3 mm2/s, t = 3.189, P = 0.002; D*: 46.45 (30.30,55.53) ×10- 3 mm2/s vs. 32.30 (18.60,40.95) ×10- 3 mm2/s, z=-2.408, P = 0.016; f: 0.45 ± 0.12 vs. 0.37 ± 0.12, t = 2.538, P = 0.014]. The ADC, D and f values of the lymph nodes-positive (N+) group were significantly lower than those of lymph nodes-negative (N0) group [ADC: (2.10 ± 0.33) ×10- 3 mm2/s vs. (2.55 ± 0.40) ×10- 3 mm2/s, t=-4.564, P < 0.001; D: (1.44 ± 0.30) ×10- 3 mm2/s vs. (1.78 ± 0.37) ×10- 3 mm2/s, t=-3.726, P < 0.001; f: 0.32 ± 0.10 vs. 0.45 ± 0.11, t=-4.524, P < 0.001]. The combination of D, D* and f yielded the highest area under the curve (AUC) (0.814) in distinguishing group T1 + T2 from group T3 + T4a. D combined with f provided the highest diagnostic performance (AUC = 0.849) in identifying group N + and group N0 of ESCC.Conclusions: IVIM may be used as an effective functional imaging technique to evaluate preoperative stage of primary tumour and predict presence of lymph node metastases from ESCC.","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"24 1","pages":"116"},"PeriodicalIF":3.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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