论著摘要 |【多模态】FLT-PET / MRI对肾癌早期治疗反应表征的放射学分析:概念证明研究(双语版)

2017-08-20 09:18:05 admin 13

Radiomics Analysis on FLT-PET/MRI for Characterization of Early Treatment Response in RenalCell Carcinoma: A Proof-of-Concept Study.

发表日期:2016.4.9    来源:Transl Oncol. 

作者:Antunes J1Viswanath S2Rusu M3Valls L4Hoimes C5Avril N5Madabhushi A2.

作者介绍

    1.Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Ave, Wickenden 525, Cleveland, OH 44106. 

    2.Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Ave, Wickenden 525, Cleveland, OH 44106.

    3.General Electric Global Research, 1 Research Cir, Niskayuna, NY 12309.

    4.Department of Radiology, Case Western Reserve University, Case Center for Imaging Research, 11000 Euclid Ave, Cleveland, OH 44106.

    5.Department of Medicine, University Hospitals Seidman Cancer Center at the Case Comprehensive Cancer Center, 11000 Euclid Ave, Cleveland, OH 44106.


摘要

研究癌症治疗过程中病人的早期反应对于其治疗分层以及随访都非常的重要。虽然最近在正电子发射断层成像(positron emission tomography, PET)和核磁共振成像 (magnetic resonance imaging, MRI)方面的进展已经可以对肿瘤反应做出评估,定量客观评价可以对肿瘤区域的结构和功能的变化的评价达到定点和定量。放射组学是利用计算机提取放射影像的特征,通过量化特征可以提取肿瘤区域微妙的变化,而这些变化可能人类没有观察到,这对于肿瘤治疗的检测也是一种新的策略。这项研究的目的是阐明在转移性肾细胞癌(RCC)的舒尼替疗法的早期反应诊疗中将放射组学分析法应用到PET/MRI的可行性。对两位晚期的转移性肾细胞癌患者利用PET/MRI扫描仪进行成像, [18F]胸腺嘧啶(FLT)是作为PET的放射性示踪物,可以用来测量细胞的增殖。图像采集包括舒尼替疗法前的检测和再检测(test/retest)和[18F]FLT-PET作用3周后,T2加权(T2w)和磁共振弥散加权成像(DWI),而DWI可以最终得到一个表观弥散系数(ADC)图谱。我们的框架工作是定量的分析治疗引起的相关变化,主要涉及下面的分析步骤:1)内外相结合的策略可以对放射组学特征的变化提供立体像素对比,2)对于T2w的修正和伪量化分析可以去除采集的人为因素和研究组织特定反应,3)对于T2w,FLT/PET和ADC的信息提取特征描述,4)通过整合多种参数信息对于PET/MRI的影像特征变化提供整合的图谱。相比较MRI的T2w分析的高变异,标准摄取值(来自FLT-PET)和ADC由于其在test/retest评估过程中的高重复性排名较高,以及可以捕获治疗过程中的反应。和治疗前的参数相比,高排名的放射组学分析法在RCC区域可以得到63%归一化百分比变化,而在空间上分离的正常区域用17%的变化。通过对比发现,在原来的和处理后的T2w的信号强度似乎对于肿瘤内部变化的灵敏性较低。我们前期的结果表明放射组学分析对于整合PET/MRI治疗反应特征分析会是一个非常有力的工具。

Studying early response to cancer treatment is significant for patient treatment stratification and follow-up. Although recent advances in positron emission tomography (PET) and magnetic resonance imaging (MRI) allow for evaluation of tumor response, a quantitative objective assessment of treatment-related effects offers localization and quantification of structural and functional changes in the tumor region. Radiomics, the process of computerized extraction of features from radiographic images, is a new strategy for capturing subtle changes in the tumor region that works by quantifying subvisual patterns which might escape human identification. The goal of this study was to demonstrate feasibility for performing radiomics analysis on integrated PET/MRI to characterize early treatment response in metastatic renalcell carcinoma (RCC) undergoing sunitinib therapy. Two patients with advanced RCC were imaged using an integrated PET/MRI scanner. [18 F] fluorothymidine (FLT) was used as the PET radiotracer, which can measure the degree of cell proliferation. Image acquisitions included test/retest scans before sunitinib treatment and one scan 3 weeks into treatment using [18 F] FLT-PET, T2-weighted (T2w), and diffusion-weighted imaging (DWI) protocols, where DWI yielded an apparent diffusion coefficient (ADC) map. Our framework to quantitatively characterize treatment-related changes involved the following analytic steps: 1) intraacquisition and interacquisition registration of protocols to allow voxel-wise comparison of changes in radiomic features, 2) correction and pseudoquantification of T2w images to remove acquisition artifacts and examine tissue-specific response, 3) characterization of information captured by T2w MRI, FLT-PET, and ADC via radiomics, and 4) combining multiparametric information to create a map of integrated changes from PET/MRI radiomic features. Standardized uptake value (from FLT-PET) and ADC textures ranked highest for reproducibility in a test/retest evaluation as well as for capturing treatmentresponse, in comparison to high variability seen in T2w MRI. The highest-ranked radiomic feature yielded a normalized percentage change of 63% within the RCC region and 17% in a spatially distinct normal region relative to its pretreatment value. By comparison, both the original and postprocessed T2w signal intensity appeared to be markedly less sensitive and specific to changes within the tumor. Our preliminary results thus suggest that radiomics analysis could be a powerful tool for characterizing treatment response in integrated PET/MRI.


阅读原文:10.1016/j.tranon.2016.01.008


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