增强CT联合纹理分析对于胰腺导管内乳头状黏液性肿瘤恶性潜能的预测价值

目的:探讨增强CT图像的纹理分析对胰腺导管内乳头状黏液性肿瘤(Intraductal papillary mucinous neoplasm,IPMN)恶性潜能的预测价值.方法:回顾性收集2010年1月-2019年12月经手术病理证实为分支胰管型IPMN(Branch duct IPMN,BD-IPMN)或混合型IPM...

Contrast enhanced CT combined with texture analysis for predicting the malignant potential of intraductal papillary mucinous neoplasm of the pancreas

Objective:To explore the predictive value of texture analysis based on contrast enhanced CT images for the malignant potential of intraductal papillary mucinous neoplasm(IPMN)of the pancreas.Methods:A total of 103 patients pathologically confirmed branch duct IPMN(BD-IPMN)or mixed type IPMN(MT-IPMN)who underwent contrast enhanced CT within 1 month before the operation were collected retrospectively from January 2010 to December 2019.The patients were divided into low-risk group of 67 cases and high-risk group of 36 cases.The lesions were evaluated by conventional way of imaging,and multivariable Logistic regression analysis was performed on clinical and conventional imaging features which showed significant differences between the two groups to determine independent predictors.Frontier,post-processing software,was used to extract texture features.Redundant features with correlation coefficient greater than 0.9 were removed and then Lasso-Logistic regression was performed to select texture features.The selected clinical and conventional imaging features and texture features were used to establish prediction models with Logistic regression.10-fold cross validation method was used to evaluate the generalization ability of the prediction models with the ROC curves.Results:Elevated level of CA 19-9,mural nodule≥5 mm,truncation of pancreatic duct with distal pancreatic atrophy,and lymphadenopathy were independent predictors of the malignant IPMN.Eight features with coefficients greater than 0.1 were selected from the 1691 texture features.The prediction model established by clinical and conventional imaging features showed AUC of 0.777(0.664~0.890),the prediction model by texture features showed AUC of 0.895(0.833~0.957),and the combined prediction model showed AUC of 0.881(0.813~0.948).Conclusion:Texture analysis based on enhanced CT images showed better performance for predicting the malignant potential of IPMN.