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1. 复旦大学附属肿瘤医院超声科,复旦大学上海医学院肿瘤学系,上海,200032
2. 复旦大学电子工程系,上海,200433
网络首发:2017-06-02,
纸质出版:2017-06-02
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李佳伟, 时兆婷, 郭翌, 等. 超声影像组学对浸润性乳腺癌激素受体表达预测价值的探索性研究[J]. 肿瘤影像学, 2017,26(2):128-135.
李佳伟,时兆婷,郭翌,等. 超声影像组学对浸润性乳腺癌激素受体表达预测价值的探索性研究[J]. 肿瘤影像学, 2017, 26(2): 128-135
目的:
探讨超声影像组学定量特征对浸润性乳腺癌激素受体表达的预测价值。
方法:
回顾性分析204例浸润性乳腺癌患者的术前超声图像及术后病理结果。根据雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)及人表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)表达,将患者分为两组:激素受体阳性组(ER
+
、PR
+
、HER-2
-
),激素受体阴性组(ER
-
、PR
-
、HER-2
-
)。两名具有5年以上临床经验的超声科医师对乳腺癌肿块超声图像进行回顾性特征分析与评估,评估内容包括肿块的形态、边缘、内部回声、后方回声改变及钙化。然后,对同一个肿块利用基于相位信息的动态轮廓模型进行边缘分割。通过t检验,筛选出与激素受体相关性最强的特征参数,通过支持向量机分类器,运用径向基核函数进行分析与研究。为减少偏倚,采用留一法对分类性能进行验证。
结果:
激素受体阳性组与阴性组在形态、边缘毛刺成角、内部回声及后方回声改变等二维特征方面存在显著统计学差异(
P
0.05)。定量分析选出54个定量特征,对激素受体表达具有较高准确率(准确率67.7%,曲线下面积73.2%)。此外,边缘、内部回声、后方回声及钙化等定量特征在激素受体阳性与阴性组之间均存在显著统计学差异(
P
0.05)。
结论:
超声影像组学定量特征分析降低了传统超声影像的主观性,在预测浸润性乳腺癌激素受体表达方面具有较大优势,其在提高超声影像学特征对乳腺癌精准诊断及生物学行为预测方面的价值仍需进一步研究。
Objective:
To investigate the automatic radiomics approach in predicting the association between quantitativeultrasound features and hormone receptor status in invasive breast carcinoma.
Methods:
A total of 204 patients who accepted breast cancer surgery were retrospectively reviewed f
or pre-operative ultrasound images and post-operative pathological reports. Based on the expressions of estrogen receptor (ER)
progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2)
all patients were divided into hormone receptor positive (ER
+
PR
+
HER-2
-
) group and hormone receptor negative (ER
-
PR
-
HER-2
-
) group. Two dimensional features of shape
margin
echo pattern
posterior acoustic feature and calcification were assessed by two experienced radiologists and correlated with hormone receptor status. The same ultrasound images were then segmented for using a phase-based active contour model. The high-throughput radiomics features were extracted based on the two dimensional sonographic features. Target features were selected using Students t-test. The support vector machine classifier with radial basis function and leave-oneout-cross-validation were used to correlate quantitative sonographic features with the status of hormone receptor.
Results:
The two groups had significant differences in the objective sonographic characteristics of shape
angular/spiculated margin
echo pattern and posterior acoustic feature (
P
0.05). In the quantitative radiomics analysis
54 features were selected with high accuracy in predicting the status of hormone receptor (accuracy 67.7%
area under the curve 73.2%). In addition
in the quantitative analysis
the two groups showed significant difference in margin
echo pattern
posterior acoustic pattern and calcification (
P
0.05).
Conclusion:
The quantitative features of ultrasound radiomics were well correlated with hormone receptor status of invasive breast carcinoma. Further study is warranted to validate its value in the precise diagnosis and biological behavior prediction of breast carcinoma.
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