磁共振成像2025，Vol.16Issue(3)：63-69,95,8.DOI:10.12015/issn.1674-8034.2025.03.010
全瘤ADC直方图参数联合影像生物标志物预测直肠腺癌神经脉管浸润的价值
The value of combining whole-tumor ADC histogram parameters with imaging biomarkers in predicting perineural and lymphovascular invasion in rectal adenocarcinoma
摘要
Abstract
Objective:To explore the value of combining whole-tumor apparent diffusion coefficient(ADC)histogram parameters with imaging biomarkers in predicting perineural invasion(PNI)and lymphovascular invasion(LVI)in rectal adenocarcinoma.Materials and Methods:A retrospective analysis was conducted on the preoperative clinical and magnetic resonance imaging(MRI)data of 102 patients with pathologically confirmed rectal adenocarcinoma.Based on pathological results,patients were divided into two groups:the PNI/LVI-positive group(with either or both PNI and LVI positive)and the PNI/LVI-negative group(both PNI and LVI negative).Using FireVoxel software,regions of interest(ROIs)were delineated to obtain ADC histogram parameters of the primary tumor,including ADC mean(ADC-mean),standard deviation,coefficient of variation,entropy,skewness,and the 1st,5th,10th,25th,50th,75th,90th,95th,and 99th percentiles of ADC(ADC-1%,ADC-5%,ADC-10%,ADC-25%,ADC-50%,ADC-75%,ADC-90%,ADC-95%,ADC-99%).Differences in ADC histogram parameters,MRI assessment extramural venous invasion(mrEMVI)status,tumor location,mrT stage,and mrN stage between the PNI/LVI-positive and negative groups were analyzed.Parameters with statistically significant differences(P<0.05)were selected through univariate analysis and used to construct a multivariate logistic regression model(ADC histogram model).Additionally,non-histogram parameters that were also statistically significant(P<0.05)in univariate analysis were included in a multivariate logistic regression analysis to establish a combined predictive model.The predictive performance of the ADC histogram model and the combined model was evaluated using receiver operating characteristic(ROC)curve analysis,and the DeLong test was used to compare the differences in the area under the curve(AUC)between the models.Results:Significant differences were observed between the PNI/LVI-positive and negative groups in ADC-mean,standard deviation,ADC-1%,ADC-75%,ADC-95%,ADC-99%,and mrEMVI(P<0.05).Among these continuous variables,ADC-99%had the highest diagnostic performance(AUC,sensitivity,and specificity were 0.835,77.1%,and 86.6%,respectively).The combined model,constructed using ADC-mean,standard deviation,ADC-1%,ADC-75%,ADC-95%,ADC-99%,and mrEMVI,had an AUC,sensitivity,and specificity of 0.918,89.6%,and 82.9%,respectively,outperforming the histogram model(AUC=0.898)and individual whole-tumor ADC histogram parameters(AUC=0.670 to 0.835).In addition to the combined model and the histogram model,there were statistically significant differences between the two models and the histogram parameters(P<0.05).Conclusions:Whole-tumor ADC histogram parameters and imaging biomarkers(mrEMVI)can be used to predict the neurovascular status of rectal adenocarcinoma preoperatively.The predictive value is higher when both are combined.关键词
直肠腺癌/神经脉管浸润/磁共振成像/表面扩散系数/直方图/影像生物标志物Key words
rectal adenocarcinoma/perineural and lymphovascular invasion/magnetic resonance imaging/apparent diffusion coefficient/histogram/imaging biomarkers分类
医药卫生引用本文复制引用
王海升,袁隆,朱凯博,席华泽,刘建强,雒攀,高榕,周俊林,刘宏..全瘤ADC直方图参数联合影像生物标志物预测直肠腺癌神经脉管浸润的价值[J].磁共振成像,2025,16(3):63-69,95,8.基金项目
National Natural Science Foundation of China(No.82260361) （No.82260361）
Lanzhou University Second Hospital"Cuiying Science and Technology Innovation Plan"Basic Research Project-Young Project(No.CY2022-QN-A10). 国家自然科学基金项目(编号:82260361) （No.CY2022-QN-A10）
兰州大学第二医院"萃英科技创新计划"应用基础研究项目-青年项目(编号:CY2022-QN-A10) （编号:CY2022-QN-A10）
