非转移性结肠癌根治性切除术患者肝脏体积、临床病理特征与存活率之间的关系

IF 2.2 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2024-02-28 DOI:10.3390/tomography10030027
Josh McGovern, Charles Mackay, Rhiannon Freireich, Allan M Golder, Ross D Dolan, Paul G Horgan, David Holroyd, Nigel B Jamieson, Donald C McMillan
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引用次数: 0

摘要

简介:CT 导出的肝脏体积对癌症预后的价值尚不明确。本研究旨在探讨结肠癌患者单个轴向 CT 切片上的肝脏面积与肝脏总体积之间的关系。此外,我们还研究了使用这种新方法确定的肝脏体积与临床病理变量和生存之间的关系:方法:我们从一个前瞻性数据库中找到了接受结肠癌根治手术的连续患者。通过在 PACS 查看器中手动分割术前 CT 图像,获得轴向 CT 切片上肝脏的最大面积(平方厘米)和总体积(立方厘米)。最大肝脏面积根据身高2 进行归一化处理,得出肝脏指数(LI)和数值,并将其分为三等分。主要研究结果是总生存率(OS)。采用卡方分析和二元逻辑回归检验了肝脏指数与临床病理变量之间的关系。采用cox比例危险回归法检验LI与OS之间的关系:结果:共纳入 359 例患者。男性患者占 51%(n = 182),73%(n = 261)的患者年龄在 65 岁或以上。81%(n = 305)的患者术后 3 年仍存活。轴向 CT 切片上的最大肝脏面积中位数为 178.7 (163.7-198.4) 平方厘米。肝脏总体积中位数为 1509.13 (857.8-3337.1) cm3。肝脏最大面积与肝脏总体积密切相关(R2 = 0.749)。中位肝面积为 66.8 (62.0-71.6) cm2/m2。在多变量分析中,年龄(P < 0.001)、性别(P < 0.05)、体重指数(BMI)(P < 0.001)和 T2DM(P < 0.05)仍与肝脏最大面积显著相关。单变量分析显示,LI(连续)或LI(三等分)与OS均无明显相关性(分别为p = 0.582和p = 0.290):本研究中提出的利用CT成像量化肝脏体积的简单、可靠的方法在观察者之间具有良好的相关性,其结果与当代文献一致。这种方法有助于在未来的癌症研究中进一步检查肝脏体积。
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The Relationship between Liver Volume, Clinicopathological Characteristics and Survival in Patients Undergoing Resection with Curative Intent for Non-Metastatic Colonic Cancer.

Introduction: The prognostic value of CT-derived liver volume in terms of cancer outcomes is not clear. The aim of the present study was to examine the relationship between liver area on a single axial CT-slice and the total liver volume in patients with colonic cancer. Furthermore, we examine the relationship between liver volume, determined using this novel method, clinicopathological variables and survival.

Methods: Consecutive patients who underwent potentially curative surgery for colonic cancer were identified from a prospectively maintained database. Maximal liver area on axial CT-slice (cm2) and total volume (cm3), were obtained by the manual segmentation of pre-operative CT-images in a PACS viewer. The maximal liver area was normalized for body height2 to create the liver index (LI) and values, categorized into tertiles. The primary outcome of interest was overall survival (OS). Relationships between LI and clinico-pathological variables were examined using chi-square analysis and binary logistic regression. The relationship between LI and OS was examined using cox proportional hazard regression.

Results: A total of 359 patients were included. A total of 51% (n = 182) of patients were male and 73% (n = 261) were aged 65 years or older. 81% (n = 305) of patients were alive 3-years post-operatively. The median maximal liver area on the axial CT slice was 178.7 (163.7-198.4) cm2. The median total liver volume was 1509.13 (857.8-3337.1) cm3. Maximal liver area strongly correlated with total liver volume (R2 = 0.749). The median LI was 66.8 (62.0-71.6) cm2/m2. On multivariate analysis, age (p < 0.001), sex (p < 0.05), BMI (p < 0.001) and T2DM (p < 0.05) remained significantly associated with LI. On univariate analysis, neither LI (continuous) or LI (tertiles) were significantly associated with OS (p = 0.582 and p = 0.290, respectively).

Conclusions: The simple, reliable method proposed in this study for quantifying liver volume using CT-imaging was found to have an excellent correlation between observers and provided results consistent with the contemporary literature. This method may facilitate the further examination of liver volume in future cancer studies.

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来源期刊
Tomography
Tomography Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
2.70
自引率
10.50%
发文量
222
期刊介绍: TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.
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