Purpose: To evaluate MR-derived whole-tumor histogram analysis parameters in predicting the aggressiveness of pancreatic ductal adenocarcinoma (PDAC). Material and methods: Pre-operative MR images of 127 consecutive patients with PDAC were retrospectively analyzed. T1-/T2-weighted images and apparent diffusion coefficient (ADC) maps were analyzed. Histogram-derived parameters were compared to several pathological features (grade, vascular infiltration, and nodal metastases) using Mann-Whitney U test. Diagnostic accuracy was assessed by receiver operating characteristic area under curve (ROC-AUC) analysis; sensitivity and specificity were assessed for each histogram parameter. Results: No significant differences were found among histogram parameters for the prediction of tumor grade. ADCentropy was significantly higher in PDACs with vascular involvement (p=.022; AUC=.641), with specificity of 92.2%. ADCskewness was significantly higher in PDACs with nodal metastases (p=.027; AUC=.642), with 72% specificity. No significant differences between groups were found for other histogram-derived parameters (p >.05). Conclusion: Whole-tumor histogram analysis of ADC values is a valuable tool for predicting the aggressiveness of PDACs. Our results indicate that histogram metrics related to intra-tumor heterogeneity are the most accurate parameters for the identification of PDACs with higher biological aggressiveness.
Histogram analysis of MR images: assessment of intra-tumoral heterogeneity and correlation with the biological behavior of pancreatic ductal adenocarcinoma
R. De Robertis;N. Cardobi;R. Negrelli;D’Onofrio Mirko;S. Montemezzi
2019-01-01
Abstract
Purpose: To evaluate MR-derived whole-tumor histogram analysis parameters in predicting the aggressiveness of pancreatic ductal adenocarcinoma (PDAC). Material and methods: Pre-operative MR images of 127 consecutive patients with PDAC were retrospectively analyzed. T1-/T2-weighted images and apparent diffusion coefficient (ADC) maps were analyzed. Histogram-derived parameters were compared to several pathological features (grade, vascular infiltration, and nodal metastases) using Mann-Whitney U test. Diagnostic accuracy was assessed by receiver operating characteristic area under curve (ROC-AUC) analysis; sensitivity and specificity were assessed for each histogram parameter. Results: No significant differences were found among histogram parameters for the prediction of tumor grade. ADCentropy was significantly higher in PDACs with vascular involvement (p=.022; AUC=.641), with specificity of 92.2%. ADCskewness was significantly higher in PDACs with nodal metastases (p=.027; AUC=.642), with 72% specificity. No significant differences between groups were found for other histogram-derived parameters (p >.05). Conclusion: Whole-tumor histogram analysis of ADC values is a valuable tool for predicting the aggressiveness of PDACs. Our results indicate that histogram metrics related to intra-tumor heterogeneity are the most accurate parameters for the identification of PDACs with higher biological aggressiveness.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.