常规MRI分形参数预测成人2～3级弥漫性胶质瘤IDH1突变状态的研究
Study of conventional MRI fractal parameters in predicting IDH1 mutation status of adult grade 2-3 diffuse gliomas
王玉瑶 1张瑾 1乔书琪 1杨洋 1胡玉川 1颜林枫 1崔光彬1
作者信息
- 1. 710038 陕西西安,空军军医大学附属第二医院放射诊断科
- 折叠
摘要
目的 评估常规MRI分形参数预测成人2～3级弥漫性胶质瘤异柠檬酸脱氢酶1(IDH1)突变状态的效能.方法 回顾性分析我院2017年2月-2019年4月经手术及活检病理证实为2～3级弥漫性胶质瘤且IDH1突变状态明确的151例患者临床及影像资料,其中IDH1突变型(IDH1mut)118例,IDH1野生型(IDH1wt)33例.所有患者术前两周内采集平扫MRI.两名放射科医师基于液体衰减反转恢复(FLAIR)图像完成全肿瘤兴趣区勾画,利用Image J及FracLac插件提取该区域的分形维数(FD)及空隙度(LAC)参数,并采用Mann-Whitney U检验比较两组间分形参数差异.采用组内相关系数(ICC)评价两名医师提取定量参数的观察者内及观察者间一致性.二元Logistic回归用于构建联合参数(FD+LAC)诊断模型.利用受试者工作特征(ROC)曲线评价不同参数/模型诊断效能.不同参数/模型效能比较采用DeLong检验.结果 FD、LAC参数的观察者内及观察者间一致性均较好(ICC均＞0.8).IDH1wt组FD值(1.274)及LAC值(0.434)中位数均高于IDH1mut组(FD:1.192;LAC:0.370),差异具有统计学意义(P均＜0.001).ROC分析结果显示,FD、LAC及联合参数模型(FD+LAC)在预测成人2～3级弥漫性胶质瘤IDH1突变状态曲线下面积为0.818、0.860、0.903,敏感度为0.780、0.822、0.805,特异度为0.818、0.788、0.849.结论 基于常规MRI的分形分析参数有助于预测成人2～3级弥漫性胶质瘤IDH1突变状态.联合参数模型(FD+LAC)具有良好的诊断效能.
Abstract
Objective To evaluate the effectiveness of conventional MRI fractal parameters in predicting the isocitrate dehydrogenase 1(IDH1)mutation status of adult grade 2-3 diffuse gliomas.Methods A retrospective analysis of the clinical and MRI data was conducted from 151 patients with pathologically confirmed grade 2-3 diffuse gliomas and IDH1 mutation status of IDH1 mutant type(IDH1mut:118)and wild type(IDH1wt:33).The entire tumor region of interest(ROI)was delineated on the fluid attenuated inversion recovery(FLAIR)images by two radiologists independently.The fractal dimension(FD)and lacunarity(LAC)parameters of the ROI were extracted using Image J and FracLac plug-ins.Mann-Whitney U test was used to compare the differences of these parameters between the two groups.Intraclass correlation coefficient(ICC)was applied to evaluate the intra-observer and inter-observer consistency of quantitative parameters extracted by the two radiologists.Binary logistic regression was utilized to construct a combined parameter(FD+LAC)diagnostic model.The diagnostic efficacy of different parameters/models was analyzed using the receiver operating characteristic(ROC)curve.The DeLong test was performed to compare the efficacy of different parameters/models.Results Intra-and inter-observer reliability was good for FD and LAC parameters(both ICC＞0.8).The median FD value(1.274)and LAC value(0.434)of IDH1wt group were both significantly(P＜0.001)higher than those of IDH1mut group(FD:1.192;LAC:0.370).The areas under ROC curves of the IDH1 mutation status prediction were 0.818 with 78.0％sensitivity and 81.8％specificity for FD,0.860 with 82.2％sensitivity and 78.8％specificity for LAC,and 0.903 with 80.5％sensitivity and 84.9％specificity for FD+LAC.Conclusion Conventional MRI fractal analysis is useful for predicting IDH1 mutation status in grade 2-3 diffuse gliomas of adults.The combined parametric FD+LAC model shows greater diagnostic effectiveness compared to individual parameters.
关键词
磁共振成像/分形维数/空隙度/弥漫性胶质瘤/异柠檬酸脱氢酶1Key words
Magnetic resonance image/Fractal dimension/Lacunarity/Diffuse gliomas/Isocitrate dehydrogenase 1引用本文复制引用
基金项目
国家自然科学基金(82102127)
空军军医大学第二附属医院青年自主创新科学基金(2023ATDQN014)
出版年
2024
NETL
NSTL
万方数据