无远处转移鼻咽癌18F-FDG PET/CT病灶的神经网络自动分类及预后预测

IF 9.6 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Nuclear Medicine Pub Date : 2025-05-09 DOI:10.1097/RLU.0000000000005942

Yuhu Lv, Danzha Zheng, Ruiping Wang, Zhangyongxue Zhou, Zairong Gao, Xiaoli Lan, Chunxia Qin

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引用次数: 0

摘要

目的：评价PET辅助报告系统（PARS）对鼻咽癌（NPC）无远处转移患者的诊断价值，探讨代谢参数对鼻咽癌预后的影响。患者和方法：回顾性收集83例鼻咽癌患者行18F-FDG PET/CT预处理。首先，以组织病理学为金标准，计算PARS诊断恶性病变的敏感性、特异性和准确性。接下来，使用PARS和人工分割获得原发肿瘤的代谢参数。分析两种方法的差异和一致性。最后，评估PET代谢参数的预后价值。进行无进展生存期（PFS）和总生存期（OS）的预后分析。结果：PARS具有较高的基于患者的准确性（97.2%）、敏感性（88.9%）和特异性（97.4%），基于病变的准确性分别为96.7%、84.0%和96.9%。人工分割的肿瘤代谢体积（MTV）和总病灶糖酵解（TLG）高于PARS。两种方法的代谢参数高度相关且一致。ROC分析显示，代谢参数在预测预后方面存在差异，但总体上在预测3年PFS和OS方面表现良好。MTV和年龄是独立的预后因素；结合这些因素的Cox比例风险模型显示出显著的预测性改进。Kaplan-Meier分析综合指标证实低危组预后较好(χ²= 42.25,P < 0.001；χ²= 20.44,p < 0.001)。结论：初步验证PARS在鼻咽癌无远处转移患者中对病变的识别和分类具有较高的诊断敏感性和准确性，代谢参数与手工相关良好。MTV反映预后，与年龄结合可增强预后预测和风险分层。

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Neural Network-based Automated Classification of 18F-FDG PET/CT Lesions and Prognosis Prediction in Nasopharyngeal Carcinoma Without Distant Metastasis.

Purpose: To evaluate the diagnostic performance of the PET Assisted Reporting System (PARS) in nasopharyngeal carcinoma (NPC) patients without distant metastasis, and to investigate the prognostic significance of the metabolic parameters.

Patients and methods: Eighty-three NPC patients who underwent pretreatment 18F-FDG PET/CT were retrospectively collected. First, the sensitivity, specificity, and accuracy of PARS for diagnosing malignant lesions were calculated, using histopathology as the gold standard. Next, metabolic parameters of the primary tumor were derived using both PARS and manual segmentation. The differences and consistency between the 2 methods were analyzed. Finally, the prognostic value of PET metabolic parameters was evaluated. Prognostic analysis of progression-free survival (PFS) and overall survival (OS) was conducted.

Results: PARS demonstrated high patient-based accuracy (97.2%), sensitivity (88.9%), and specificity (97.4%), and 96.7%, 84.0%, and 96.9% based on lesions. Manual segmentation yielded higher metabolic tumor volume (MTV) and total lesion glycolysis (TLG) than PARS. Metabolic parameters from both methods were highly correlated and consistent. ROC analysis showed metabolic parameters exhibited differences in prognostic prediction, but generally performed well in predicting 3-year PFS and OS overall. MTV and age were independent prognostic factors; Cox proportional-hazards models incorporating them showed significant predictive improvements when combined. Kaplan-Meier analysis confirmed better prognosis in the low-risk group based on combined indicators (χ² = 42.25, P < 0.001; χ² = 20.44, P < 0.001).

Conclusions: Preliminary validation of PARS in NPC patients without distant metastasis shows high diagnostic sensitivity and accuracy for lesion identification and classification, and metabolic parameters correlate well with manual. MTV reflects prognosis, and its combination with age enhances prognostic prediction and risk stratification.

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来源期刊

Clinical Nuclear Medicine 医学-核医学

CiteScore

2.90

自引率

31.10%

发文量

1113

审稿时长

2 months

期刊介绍： Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty. Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.