期刊
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS
卷 32, 期 12, 页码 1672-1680出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejmp.2016.09.003
关键词
Head-and-neck lymph-nodes; Texture analysis; T2w-MRI; DW-MRI
Purpose: In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemoradiotherapy (CRT). Methods: 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6 months, 19 LNs showed regional control, while 11 LNs showed regional failure at a median time of 4.6 months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Results: Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80%); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy = 82.8%). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8%). Conclusion: Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT. (C) 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
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