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CT纹理分析评估胸腺肿瘤和胸腺增生:与国际胸腺恶性肿瘤(ITMIG)分期和WHO分级的相关 ...

已有 211 次阅读2021-10-14 10:51 |个人分类:TET学习|系统分类:医学科学| 胸腺瘤, 胸腺增生

CT纹理分析评估胸腺肿瘤和胸腺增生:与国际胸腺恶性肿瘤(ITMIG)分期和WHO分级的相关性.
CT texture analysis in evaluation of thymic tumors and thymic hyperplasia: correlation with the international thymic malignancy interest group (ITMIG) stage and WHO grade
目的:评估 CT 纹理分析 (CTTA) 在 (1) 区分胸腺瘤 (THY) 与胸腺增生 (TH) (2) 低与高 WHO 等级,以及 (3) 低与高 Masaoka Koga (MK)/国际胸腺恶性肿瘤兴趣小组 (ITMIG) 阶段。

方法:在获得伦理审查后,这项横断面研究分析了 26 名在 2016 年 1 月至 2018 年 12 月期间接受双能 CT(DECT)和手术的患者(THY-18、TH-8)。 CTTA 使用 TexRad(Feedback Medical Ltd ., Cambridge, UK- www.fbkmed.com) 由一位观察者提供。自由手感兴趣区域 (ROI) 被放置在轴向截面上,那里有最大的增强和均匀性。过滤直方图用于在六个空间缩放因子“SSF 0、2、3、4 、5 和 6 英寸。 Mann-Whitney 检验适用于各种类别,p 值 < 0.05 被认为是显着的。执行三步特征选择以确定每个类别中的最佳参数。

结果:表现最佳的参数是 (1) THY 与 TH-“SSF 0” (AUC: 0.8889) 的平均值和“SSF 0” (AUC: 0.8889) 的 MPP,(2) WHO 等级低与高 - 未显示参数具有良好 AUC 的统计显着性,以及 (3) 低与高 MK/ITMIG 阶段-“SSF 6”的 SD(AUC:分别为 0.8052 和 0.8333])。

结论:CTTA 揭示了几个参数,在区分胸腺瘤与胸腺增生以及 MK/ITMIG 高与低阶段方面具有出色的诊断性能。 CTTA 可能作为这种分层的非侵入性工具。

知识进步:这项研究采用了纹理分析,这是一种新的 DECT 扫描放射组学方法,以确定最佳性能参数及其相应的截止值,以区分上述类别。这些新参数可能有助于为无创分层和准确预测患者增加另一层信心,这在以前只能通过活检才能实现。

Objectives: To evaluate the effectiveness of CT texture analysis (CTTA) in (1) differentiating Thymoma (THY) from thymic hyperplasia (TH) (2) low from high WHO grade, and (3) low from high Masaoka Koga (MK)/International Thymic Malignancy Interest Group (ITMIG) stages.

Methods: After institute ethical clearance, this cross-sectional study analyzed 26 patients (THY-18, TH-8) who underwent dual energy CT (DECT) and surgery between January 2016 and December 2018. CTTA was performed using TexRad (Feedback Medical Ltd., Cambridge, UK- www.fbkmed.com) by a single observer. Free hand regions of interest (ROIs) were placed over axial sections where there was maximum enhancement and homogeneity. Filtration histogram was used to generate six first-order texture parameters [mean, standard deviation (SD), mean of positive pixels (MPP), entropy, skewness, and kurtosis] at six spatial scaling factors "SSF 0, 2, 3, 4, 5, and 6". Mann-Whitney test was applied among various categories and p value < 0.05 was considered significant. Three-step feature selection was performed to determine the best parameters among each category.

Results: The best performing parameters were (1) THY vs TH- Mean at "SSF 0" (AUC: 0.8889) and MPP at "SSF 0" (AUC: 0.8889), (2) Low vs high WHO grade - no parameter showed statistical significance with good AUC, and (3) Low vs high MK/ITMIG stage- SD at "SSF 6" (AUC: 0.8052 and 0.8333 respectively]).

Conclusion: CTTA revealed several parameters with excellent diagnostic performance in differentiating thymoma from thymic hyperplasia and MK/ITMIG high vs low stages. CTTA could potentially serve as a non-invasive tool for this stratification.

Advances in knowledge: This study has employed texture analysis, a novel radiomics method on DECT scans to determine the best performing parameter and their corresponding cut-off values to differentiate among the above-mentioned categories. These new parameters may help add another layer of confidence to non-invasively stratify and prognosticate patients accurately which was only previously possible with a biopsy.

Rajamohan N, Goyal A, Kandasamy D, Bhalla AS, Parshad R, Jain D, Sharma R. CT texture analysis in evaluation of thymic tumors and thymic hyperplasia: correlation with the international thymic malignancy interest group (ITMIG) stage and WHO grade. Br J Radiol. 2021 Oct 5:20210583. doi: 10.1259/bjr.20210583. Epub ahead of print. PMID: 34555940.

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