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Discrimination of HPV status using CT texture analysis: tumour heterogeneity in oropharyngeal squamous cell carcinomas.
Neuroradiology ( IF 2.8 ) Pub Date : 2019-10-22 , DOI: 10.1007/s00234-019-02295-w
Ji Young Lee 1 , Miran Han 2 , Kap Seon Kim 2 , Su-Jin Shin 3 , Jin Wook Choi 2 , Eun Ju Ha 2
Affiliation  

PURPOSE To evaluate the diagnostic performance of texture analysis for discriminating human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (OPSCC) in the primary tumours and metastatic lymph nodes. METHODS Ninety-five patients with primary tumour and 91 with metastatic lymph nodes with confirmed HPV status, who underwent pretreatment contrast-enhanced CT (CECT), were included as the discovery population. CT texture analysis was performed using commercially available software. Differences between HPV-positive and HPV-negative groups were analysed using the χ2 test (or Mann-Whitney U test) and independent t test (or Fisher's exact test). ROC curve analysis was performed to discriminate HPV status according to heterogeneity parameters. Diagnostic accuracy was evaluated in the separate validation population (n = 36) from an outside hospital. RESULTS HPV positivity was 52.6% for primary tumours and 56.0% for metastatic lymph nodes. The entropy and standard deviation (SD) values in the HPV-positive group were significantly lower. Entropy using the medium filter was the best discriminator between HPV-positive and HPV-negative primary OPSCCs (AUC, 0.85) and SD without the filter for metastatic lymph nodes (AUC, 0.82). Diagnostic accuracy of entropy for the primary tumour was 80.0% in the discovery group and 75.0% in the validation group. In cases of metastatic lymph node, the accuracy of SD was 79.1% and 78.8%, respectively. CONCLUSION Significant differences were found in heterogeneity parameters from texture analysis of pretreatment CECT, according to HPV status. Texture analysis could be used as an adjunctive tool for diagnosis of HPV status in clinical practice.

中文翻译:

使用CT纹理分析区分HPV状态:口咽鳞状细胞癌中的肿瘤异质性。

目的评估质地分析对原发性肿瘤和转移性淋巴结中口咽鳞状细胞癌(OPSCC)患者的人类乳头瘤病毒(HPV)状态的诊断性能。方法将95例原发性肿瘤患者和91例HPV状态确定的转移性淋巴结患者接受了预处理的对比增强CT(CECT)治疗,作为发现人群。使用商用软件进行CT纹理分析。使用χ2检验(或Mann-Whitney U检验)和独立t检验(或Fisher精确检验)分析HPV阳性和HPV阴性组之间的差异。进行ROC曲线分析以根据异质性参数区分HPV状态。在来自外部医院的独立验证人群(n = 36)中评估了诊断准确性。结果HPV阳性原发性肿瘤为52.6%,转移性淋巴结为56.0%。HPV阳性组的熵和标准差(SD)值显着降低。使用中性滤器的熵是HPV阳性和HPV阴性的原发性OPSCC(AUC,0.85)和不使用滤器的转移性淋巴结(AUC,0.82)的最佳区分。发现组中原发性熵的诊断准确性为80.0%,验证组中为75.0%。对于转移性淋巴结,SD的准确性分别为79.1%和78.8%。结论根据HPV状态,预处理CECT的质地分析发现异质性参数存在显着差异。
更新日期:2019-10-22
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