摘要
目的 探讨表观扩散系数(ADC)直方图参数在评估儿童高级别弥漫性中线胶质瘤(DMG)H3K27M突变价值.方法 回顾性搜集经本院病理证实为DMG的54例患者临床病理和影像资料.根据H3K27M突变状态分为H3K27M突变型组(n=39)和H3K27M野生型组(n=15).应用Firevoxel软件在ADC图像勾画每层整个病变感兴趣区(ROI)进行全域直方图分析.生成的ADC直方图参数包括ADC最小值(ADCmin)、ADC平均值(ADCmean)、ADC最大值(ADCmax)、偏度、峰度、标准差、变异度、变异系数、熵、ADC第1百分位数(ADC1％)、ADC第10百分位数(ADC10％)、ADC第50百分位数(ADC50％)、ADC第90百分位数(ADC90％)和ADC第99百分位数(ADC99％).采用Mann-WhitneyU检验对这些直方图参数进行组间比较.差异存在统计学意义(P≤0.05)的参数绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC)、灵敏度、特异度和约登指数.结果 H3K27M突变型的ADC直方图ADCmean、ADCmax、ADC10％、ADC50％、ADC90％和ADC99％显著低于H3K27M野生型(P均≤0.05);而H3K27M突变型DMG的ADC直方图偏度和峰度则显著高于H3K27M野生型(P均≤0.05)o ROC分析显示ADCmax评估H3K27M突变型和H3K27M野生型效能最优,AUC、敏感度、特异度和约登指数分别为0.846(0.722～0.930)、66.7％、93.3％和0.600.结论 全域ADC直方图参数能够有效评估DMG的H3K27M突变状态,有助于临床医师评估患者预后和个体化治疗.
Abstract
Objective To investigate the value of apparent diffusion coefficient(ADC)histogram parameters in the e-valuation of mutations of H3K27M in children with high grade diffuse midline glioma(DMG).Methods The clinical pathological and imaging data of 54 patients with DMG confirmed by pathology in our hospital were retrospectively collect-ed.According to the mutation status of H3K27M,they were divided into H3K27M mutant group(n=39)and H3K27M wild-type group(n=15).Firevoxel software was used to segmentate the area of interest(ROI)of entire lesion in each lay-er of the ADC image for full-volume histogram analysis.The generated ADC histogram parameters include ADC minimum value(ADCmin),ADC mean value(ADCmean),ADC maximum value(ADCmax),skewness,kurtosis,standard deviation,var-iation,coefficient of variation,entropy,ADC 1st percentile(ADC1％),ADC 10th percentile(ADC10％),ADC 50th per-centile(ADC50％),ADC 90th percentile(ADC90％),and ADC 99th percentile(ADC99％).Mann-Whitney U test was used to compare these histogram parameters between groups.Receiver operating characteristic curve(ROC)was drawn for parameters with statistically significant differences between groups(P≤ 0.05),and area under ROC curve(AUC),sensi-tivity,specificity and Yoden index were calculated.Results The H3K27M mutant had significantly lower ADCmean,ADCmax,ADC10％,ADC50％,ADC90％and ADC99％values than those of the H3K27M wild type(all P≤ 0.05),while the H3K27M mutant had significantly higher skewness and kurtosis values than those of the H3K27M wild type(all P≤0.05).The ROC analysis showed that the optimal parameter in evaluating H3K27M mutant and H3K27M wild type was ADCmax,and the AUC,sensitivity,specificity and Yoden index were 0.846(0.722-0.930),66.7％,93.3％and 0.600,respectively.Conclusion The full-volume ADC histogram parameter can effectively evaluate the H3K27M mutation status of DMG,which is helpful for clinicians to evaluate prognosis and individualized treatment for patient.
基金项目
河南省科技攻关联合共建项目(LHGJ20220759)
河南省科技攻关联合共建项目(LHGJ20220761)
NETL
NSTL
万方数据