多参数MRI影像组学在鉴别诊断T3a与T3b期前列腺癌中的价值
Value of multi-parameter MRI-based radiomics in distinguishing T3a stage from T3b stage of prostate cancer
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摘要:目的探讨多参数MRI(multi-parameter MRI, mp-MRI)影像组学在鉴别诊断T3a、T3b期前列腺癌中的价值。方法回顾性分析151例T3期前列腺癌病人的影像资料, 其中T3a期110例, T3b期41例。使用达尔文智能科研平台在T2WI及ADC横轴位图像上手动勾画感兴趣区, 提取影像组学特征。按照3:1的比例分别将ADC图像、T2WI图像、ADC图像联合T2WI图像三种模式下的影像组学特征分为训练集和验证集, 依次对3组训练集构建模型, 使用相应验证集进行内部验证。通过ROC曲线对模型进行分析, 并评价不同序列的诊断效能。结果通过达尔文科研平台共提取1878个影像组学特征, 最终保留6个(ADC相关2个, T2WI相关4个)(P < 0.05), 单独T2WI和ADC图像下训练集AUC值分别为0.79、0.71, 验证集AUC值为0.59、0.70;ADC图像联合T2WI图像下训练集AUC值为0.79, 验证集AUC值为0.73。结论T2WI图像联合ADC图像影像组学对术前鉴别T3a、T3b期前列腺癌具有较好诊断价值, 可在一定程度上弥补MRI对 < 1 mm病灶检查效果欠佳的缺陷, 为癌灶是否侵犯精囊提供补充, 协助临床术前获得更加详实的资料, 为精准手术提供指导。Abstract:ObjectiveTo investigate the value of radiomic features of multi-parameter MRI(mp-MRI) for distinguishing T3a stage from T3b stage of prostate cancer.MethodsThe imaging data of 151 patients with T3 stage prostate cancer were retrospectively analyzed, including 110 patients with T3a stage and 41 patients with T3b stage.Using DARWIN research platform, regions of interest(ROI) were manually sketched on the transverse T2WI and ADC images to extract the radiomic features of image.The imaging data of ADC, T2WI and ADC combined with T2WI were divided into training group and verification group at the ratio of 3:1.Then the model of three groups of training group was built, and the corresponding tests were used for internal verification.The diagnostic efficacy of different sequences was analyzed by the ROC curve.ResultsA total of 1878 imaging features were extracted by DARWIN research platform, and 6 features(2 features of ADC and 4 features of T2WI) were retained(P < 0.05).The AUC values of training group and validation group under simple T2WI or ADC sequence were 0.79, 0.71, 0.59, 0.70.The AUC value of training group under ADC combined with T2WI sequence was 0.79, and that of validation group was 0.73.ConclusionsT2WI combined with ADC imaging radiomics has a good auxiliary value in the preoperative differential diagnosis of T3a and T3b prostate cancer, which can make up for the defect of MRI in the diagnosis of lesions less than 1 mm and provide the supplement for the invasion of seminal vesicle to obtain more clinical preoperative detailed information and provide the guidance for accurate surgery.
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