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MRI纹理分析在识别前列腺导管内癌成分中的价值

The Value of MRI Texture Analysis in Identifying Intraductal Carcinoma of the Prostate Gland

  • 摘要:
      目的  探究基于纹理分析的影像组学方法在识别前列腺癌导管内癌(intraductal carcinoma of the prostate gland, IDCP)成分中的价值。
      方法  回顾性分析56例前列腺癌患者的磁共振成像(MRI),其中单纯腺癌患者31例,含IDCP成分腺癌患者25例。分析病灶影像学特征,然后将纳入患者的T2加权成像(T2WI),增强扫描动脉期、静脉期序列图像导入Omni-Kinetics软件进行病灶纹理特征的提取,建立基于各序列纹理参数及联合影像特征的回归预测模型。采用受试者工作特征(ROC)曲线评估各纹理模型的诊断效能。
      结果  外周带病灶影像特征中,含IDCP成分腺癌患者外科包膜侵犯、突破前列腺包膜、精囊腺侵犯发生率高于单纯腺癌患者(P<0.05);移行带病灶影像特征中,含IDCP成分腺癌患者伴前列腺增生、侵犯前列腺包膜、精囊腺侵犯和侵犯血管神经束等影像特征发生率更高(P<0.05)。在单纯腺癌与含IDCP成分腺癌的鉴别诊断中,外周带组中筛选出4个动脉期纹理特征,纹理模型和合并是否侵犯精囊腺的混合模型的曲线下面积(AUC)分别为0.890和0.938,两模型的 AUC 差异无统计学意义;移行带组中筛选出2个动脉期纹理特征和2个静脉期特征,纹理模型和合并是否侵犯血管神经束的混合模型的AUC分别为0.844和0.901,两模型的 AUC 差异无统计学意义。
      结论  含IDCP成分的腺癌伴前列腺外侵犯征象的发生率更高。在识别IDCP成分上,与T2WI相比,增强序列纹理分析的结果更具有鉴别价值。

     

    Abstract:
      Objective  To explore the value of a radiomics approach based on MRI texture analysis (TA) in identifying intraductal carcinoma of the prostate gland (IDCP).
      Methods  MRI images of 56 patients with pathological proven prostate cancer were analyzed retrospectively, including 31 patients with pure prostate adenocarcinoma and 25 patients with IDCP component in the prostate adenocarcinoma lesions. After imaging features of lesions were analyzed, then enhanced arterial and venous phase images were imported into Omni-Kinetics software for the extraction the TA features of region of interests’ lesion according to the T2-weighted imaging. In order to set up a regression prediction model which based on texture parameters and morphological features. Furthermore, the comparison of diagnostic accuracy of each TA regression models were assessed by operating characteristic curves (ROC).
      Results  Among the imaging features of peripheral lesions, the incidence of surgical capsule invasion, prostatic capsule involvement, and seminal vesicle invasion in patients with IDCP was higher than that in patients with adenocarcinoma alone (P<0.05). Among the imaging features of transitional zone lesions, patients with adenocarcinoma containing IDCP had a higher incience of imaging features as benign prostatic hyperplasia, extracapsular invasion of the prostate, seminal vesicles invasion, and vascular nerve bundles than that in pure adenocarcinoma group (P<0.05). In order to differential diagnosis of simple adenocarcinoma and adenocarcinoma containing IDCP, 4 arterial phase texture features were used to build the regression model in the peripheral zone group, and the area under the curve (AUC) of the TA model and combined model with or without seminal vesicles invasion were 0.890 and 0.938, respectively. In the transitional zone group, 2 arterial phase texture features and 2 venous phase features were used in TA regression model, and the AUC of texture model and the combined model with or without vascular nerve bundles were 0.844 and 0.901, respectively.
      Conclusion  The incidence of adenocarcinoma with IDCP is higher in high-grade invasive prostate cancer. It is wonderful that when compared with T2WI, enhanced sequential texture analysis is more valuable when using the radiomics approach based on MRI texture analysis in identifying IDCP in prostate cancer.

     

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