论著摘要 |【PET】在肺癌患者中基于FDG-PET / CT的N阶段使用密度阈值的影像学分析(双语版)

2017-12-25 11:33:03 admin 1

Radiomic Analysis using Density Threshold for FDG-PET/CT-Based N-Staging in Lung Cancer Patients.

发表日期: 2017.04.01   来源:Molecular Imaging and Biology. 2017 Apr;19(2):315-322.

作者:

Paul Flechsig1,2,3, Philipp Frank1, Clemens Kratochwil1 , Gerald Antoch4, Daniel Rath1, Jan Moltz5, Michael Rieser6, Arne Warth3,7, Hans-Ulrich Kauczor2,3 , Lawrence H. Schwartz8, Uwe Haberkorn1,9, Frederik L. Giesel1,9, Frederik L. Giesel10,11

作者介绍:

1. Department of Nuclear MedicineUniversity Hospital HeidelbergHeidelberg, Germany

2. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.

3. Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.

4. Department of Diagnostic and Interventional Radiology, University Dusseldorf, 40225, Dusseldorf, Germany.

5. Fraunhofer MEVIS, Institute for Medical Imaging Computing, Bremen, Germany.

6. Department of Nuclear Medicine and Endocrinology, Klinikum Klagenfurt, Klagenfurt, Austria.

7. Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.

8. Department of Radiology, Columbia University Medical Centre, New York, NY, USA.

9. Clinical Cooperation Unit, Department of Nuclear Medicine, DKFZ, Heidelberg, Germany.

10. Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany.

11. Clinical Cooperation Unit, Department of Nuclear Medicine, DKFZ, Heidelberg, Germany. frederik@egiesel.com.

摘要

Abstact

目的

在肺癌患者中通过整合2-脱氧-2- [18 F]氟-D-葡萄糖([18F] FDG)正电子发射断层扫描/ X线计算机断层扫描(PET / CT)来评估纵膈淋巴结(N)阶段不总是准确的。为了减少对侵入性分期手术的需要,用于检测恶性淋巴结浸润的附加替代参数将是有帮助的。本研究的目的是评估纵隔淋巴结中的放射性半自动密度分析是否可以改善临床前N期,而不考虑具体的肺癌实体。

Purpose

Mediastinal nodal (N)-staging done by integrated 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) in lung cancer patients is not always accurate. In order to reduce the need for invasive staging procedures, additional surrogate parameters for the detection of malignant lymph node infiltration would be helpful. The purpose of this study was to evaluate if radiomic semi-automated density profiling in mediastinal lymph nodes can improve preclinical N-staging, irrespective of the specific lung cancer entity.

过程

这项回顾性研究由机构审查委员会批准。研究了122例肺癌患者的二百四十八个组织学证实的淋巴结。在恶性浸润淋巴结中,特异性肺癌实体进行组织学分类;良性淋巴结组织学分类为良性。手术/活组织检查前进行非造影增强[18F] FDG-PET / CT。基于FDG摄取和体积CT直方图分析进行淋巴结采样的淋巴结分析。

Procedures

This retrospective study was approved by the institutional review board. Two hundred forty-eight histologically proven lymph nodes in 122 lung cancer patients were investigated. In malignantly infiltrated lymph nodes, the specific lung cancer entity was histologically classified; benign lymph nodes were histologically classified as benign. Non-contrast enhanced [18F]FDG-PET/CT was performed before surgery/biopsy. Lymph node analyses were performed on the basis of FDG uptake and volumetric CT histogram analysis for metric lymph node sampling.

结果

在248例淋巴结中,118例良性,130例恶性。 不论组织学亚型如何,恶性淋巴结与良性淋巴结相比具有显着更高的中位CT密度,其中恶性为(32.4Hounsfield单位(HU)(最小5.4 /最大77.5 HU)),良性为(9.3 HU(分钟-49.5 /最大60.4 HU,p<0.05))。不同恶性肿瘤亚型之间的差异通过体积密度分析失败。 无论恶性亚型如何,20HU可能的临界值可能有助于区分良性和恶性淋巴结。

Results

Of the 248 lymph nodes, 118 were benign, 130 malignant. Malignant lymph nodes had a significantly higher median CT density (32.4 Hounsfield units (HU) (min 5.4/max 77.5 HU)) compared to benign lymph nodes (9.3 HU (min −49.5/max 60.4 HU, p < 0.05), irrespective of the histological subtype. The discrimination between different malignant tumour subtypes by means of volumetric density analysis failed. Irrespective of the malignant subtype, a possible cutoff value of 20 HU may help differentiate between benign and malignant lymph nodes.

结论

在PET中具有不明显FDG摄取的不清楚的纵隔和肝门淋巴结中的密度测量可能作为肺癌患者N阶段的可能替代参数,而不考虑特定的肺癌亚型。这也有助于在需要侵入性淋巴结分期的情况下找到可能的高产量目标。

Conclusions

Density measurements in unclear mediastinal and hilar lymph nodes with equivocal FDG uptake in PET might serve as a possible surrogate parameter for N-staging in lung cancer patients, irrespective of the specific lung cancer subtype. This could also help to find possible high yield targets in cases where invasive lymph node staging is necessary.

关键词:

FDG-PET/CT,肺癌,影像组学,分期

Keywords:

FDG/PET-CT; Lung cancer; Radiomics; Staging

阅读原文:PMID: 27539308  DOI: 10.1007/s11307-016-0996-z


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