中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
3期
167-170
,共4页
王长梅%管一晖%张文强%左传涛%华逢春
王長梅%管一暉%張文彊%左傳濤%華逢春
왕장매%관일휘%장문강%좌전도%화봉춘
肺肿瘤%体层摄影术,发射型计算机%体层摄影术,X线计算机%图像处理,计算机辅助%纹理%脱氧葡萄糖
肺腫瘤%體層攝影術,髮射型計算機%體層攝影術,X線計算機%圖像處理,計算機輔助%紋理%脫氧葡萄糖
폐종류%체층섭영술,발사형계산궤%체층섭영술,X선계산궤%도상처리,계산궤보조%문리%탈양포도당
Lung neoplasms%Tomography,emission-computed%Tomography,X-ray computed%Image processing,computer-assisted%Texture%Deoxyglucose
目的 探讨18F-FDG PET/CT图像纹理特征参数对良恶性肺结节的鉴别能力,并与FDG SUVmax的诊断效能比较.方法 回顾性分析170例肺结节患者的18F-FDG PET/CT图像,其中男102例,女68例,年龄29 ～ 81(平均59)岁；恶性89例(PET图像230层),良性81例(PET图像193层).参照CT图像勾画ROI,获得病灶PET/CT图像的13项纹理特征参数值[包括均值、标准差、偏度、峰度、角二阶矩(ASM)、熵、对比性、相关性、粗糙度、对比度、频度、复杂度、强度]和SUVmax.采用logistic回归分析进行统计,提取有效的纹理参数,建立回归方程,并通过ROC曲线评估其判断肺结节良恶性的能力.利用Mann-Whitney u检验比较不同病理类型肺癌患者间纹理特征参数的差异.ROC曲线评价SUVmax对良恶性肺结节的检验效能,采用x2检验对纹理特征参数与SUVmax的诊断效能进行比较.结果 偏度、峰度、ASM和强度4项纹理特征参数与肺结节良恶性判断有关(β=1.7058、-1.0989、-4.4140和0.5626,均P＜0.05).纹理特征参数对应ROC AUC为0.775(95％ CI0.732～0.819;P＜0.001);灵敏度为89.6％ (206/230),特异性为50.8％ (98/193).89例肺癌患者中,鳞状细胞癌组(21例)和腺癌组(62例)的ASM和强度差异有统计学意义[ASM:0.0303 (95％CI0.0392～0.0724)和0.0594(95％ CI0.0721 ～0.0947)；强度:2.4714(95％ CI 2.4632 ～4.1050)和1.5945(95％ CI1.9003 ～2.4652)；u=3082.0和3115.0,均P＜0.01].ROC曲线示SUVmax诊断肺癌的AUC为0.757(95％ CI0.711 ～0.802;P＜0.001)；SUVmax ≥2.5时灵敏度为80.9％ (186/230),特异性为50.3％ (97/193).纹理特征参数与SUVmax鉴别肺结节良恶性的灵敏度差异有统计学意义(x2=6.903,P＜0.01).结论 纹理特征参数可用于18F-FDG PET显像辅助诊断肺结节良恶性；不同病理类型肺癌的纹理特征参数不同,且纹理特征参数对肺结节性质鉴别灵敏度优于SUVmax.
目的 探討18F-FDG PET/CT圖像紋理特徵參數對良噁性肺結節的鑒彆能力,併與FDG SUVmax的診斷效能比較.方法 迴顧性分析170例肺結節患者的18F-FDG PET/CT圖像,其中男102例,女68例,年齡29 ～ 81(平均59)歲；噁性89例(PET圖像230層),良性81例(PET圖像193層).參照CT圖像勾畫ROI,穫得病竈PET/CT圖像的13項紋理特徵參數值[包括均值、標準差、偏度、峰度、角二階矩(ASM)、熵、對比性、相關性、粗糙度、對比度、頻度、複雜度、彊度]和SUVmax.採用logistic迴歸分析進行統計,提取有效的紋理參數,建立迴歸方程,併通過ROC麯線評估其判斷肺結節良噁性的能力.利用Mann-Whitney u檢驗比較不同病理類型肺癌患者間紋理特徵參數的差異.ROC麯線評價SUVmax對良噁性肺結節的檢驗效能,採用x2檢驗對紋理特徵參數與SUVmax的診斷效能進行比較.結果 偏度、峰度、ASM和彊度4項紋理特徵參數與肺結節良噁性判斷有關(β=1.7058、-1.0989、-4.4140和0.5626,均P＜0.05).紋理特徵參數對應ROC AUC為0.775(95％ CI0.732～0.819;P＜0.001);靈敏度為89.6％ (206/230),特異性為50.8％ (98/193).89例肺癌患者中,鱗狀細胞癌組(21例)和腺癌組(62例)的ASM和彊度差異有統計學意義[ASM:0.0303 (95％CI0.0392～0.0724)和0.0594(95％ CI0.0721 ～0.0947)；彊度:2.4714(95％ CI 2.4632 ～4.1050)和1.5945(95％ CI1.9003 ～2.4652)；u=3082.0和3115.0,均P＜0.01].ROC麯線示SUVmax診斷肺癌的AUC為0.757(95％ CI0.711 ～0.802;P＜0.001)；SUVmax ≥2.5時靈敏度為80.9％ (186/230),特異性為50.3％ (97/193).紋理特徵參數與SUVmax鑒彆肺結節良噁性的靈敏度差異有統計學意義(x2=6.903,P＜0.01).結論 紋理特徵參數可用于18F-FDG PET顯像輔助診斷肺結節良噁性；不同病理類型肺癌的紋理特徵參數不同,且紋理特徵參數對肺結節性質鑒彆靈敏度優于SUVmax.
목적 탐토18F-FDG PET/CT도상문리특정삼수대량악성폐결절적감별능력,병여FDG SUVmax적진단효능비교.방법 회고성분석170례폐결절환자적18F-FDG PET/CT도상,기중남102례,녀68례,년령29 ～ 81(평균59)세；악성89례(PET도상230층),량성81례(PET도상193층).삼조CT도상구화ROI,획득병조PET/CT도상적13항문리특정삼수치[포괄균치、표준차、편도、봉도、각이계구(ASM)、적、대비성、상관성、조조도、대비도、빈도、복잡도、강도]화SUVmax.채용logistic회귀분석진행통계,제취유효적문리삼수,건립회귀방정,병통과ROC곡선평고기판단폐결절량악성적능력.이용Mann-Whitney u검험비교불동병리류형폐암환자간문리특정삼수적차이.ROC곡선평개SUVmax대량악성폐결절적검험효능,채용x2검험대문리특정삼수여SUVmax적진단효능진행비교.결과 편도、봉도、ASM화강도4항문리특정삼수여폐결절량악성판단유관(β=1.7058、-1.0989、-4.4140화0.5626,균P＜0.05).문리특정삼수대응ROC AUC위0.775(95％ CI0.732～0.819;P＜0.001);령민도위89.6％ (206/230),특이성위50.8％ (98/193).89례폐암환자중,린상세포암조(21례)화선암조(62례)적ASM화강도차이유통계학의의[ASM:0.0303 (95％CI0.0392～0.0724)화0.0594(95％ CI0.0721 ～0.0947)；강도:2.4714(95％ CI 2.4632 ～4.1050)화1.5945(95％ CI1.9003 ～2.4652)；u=3082.0화3115.0,균P＜0.01].ROC곡선시SUVmax진단폐암적AUC위0.757(95％ CI0.711 ～0.802;P＜0.001)；SUVmax ≥2.5시령민도위80.9％ (186/230),특이성위50.3％ (97/193).문리특정삼수여SUVmax감별폐결절량악성적령민도차이유통계학의의(x2=6.903,P＜0.01).결론 문리특정삼수가용우18F-FDG PET현상보조진단폐결절량악성；불동병리류형폐암적문리특정삼수불동,차문리특정삼수대폐결절성질감별령민도우우SUVmax.
Objective To evaluate the parametric features of image textures on 18F-FDG PET/CT for the differentiation between malignant and benign pulmonary nodules and compare the diagnostic performance of these parameters with SUVmax.Methods 18F-FDG PET/CT images of 170 patients (102 males,68 females,age range:29-81 (mean 59)years) with pulmonary nodules were retrospectively evaluated.Eightynine pulmonary nodules (230 slices) were malignant and 81 (193 slices) were benign.The pulmonary nodules were contoured on CT images and mapped to the co-registered PET images.Thirteen parameters of textural features were extracted and SUVmax was measured.Logistic regression analysis was used to identify the significant texture parameters and create a regression model.The efficacy of the textural features and SUVmax to distinguish between malignant and benign pulmonary nodules was evaluated by ROC curve analysis.The textural features of squamous cell carcinoma and adenocarcinoma were compared via the Mann-Whitney u test.The sensitivity and specificity of the textural features and SUVmax for the differential diagnosis were compared with x2 test.Results Logistic regression model identified 4 textural features (skewness (β =1.7058),kurtosis (β =-1.0989),angular second moment (ASM,3 =-4.4140) and strength (β =0.5626) ; all P ＜ 0.05) to have significant correlation with the malignancy of lung nodules.The AUC of ROC curve was 0.775 (95％ CI0.732-0.819; P＜0.001) with the sensitivity of 89.6％ (206/230) and specificity of 50.8％ (98/193).ASM and strength had statistically significant differences between squamous cell carcinoma and adenocarcinoma [ASM:0.0303 (95％ CI 0.0392-0.0724) vs 0.0594 (95％ CI 0.0721-0.0947) ; strength:2.4714 (95％ CI 2.4632-4.1050) vs 1.5945 (95％ CI 1.9003-2.4652) ; u =3082.0 and 3115.0,both P＜0.01].The AUC of SUVmax-based diagnosis was 0.757 (95％ CI 0.711-0.802 ; P ＜ 0.001) with the sensitivity of 80.9 ％ (186/230) and specificity of 50.3 ％ (97/193) at a cut-off value of 2.5.The sensitivity of the textural features was superior to SUVmax in differentiating malignant from benign pulmonary nodules (x2 =6.903,P ＜ 0.01).Conclusions Image textural parametric features extracted from 18 F-FDG PET/CT are more sensitive to differentiate between malignant and benign pulmonary nodules compared to SUVmax.They might also be useful to discriminate between different pathological types of lung cancers.
