动态碳-11甲硫氨酸PET/计算机断层扫描的影像组学分析用于鉴别良恶性肌肉骨骼病变：一项初步临床评估。
完整摘要 · 中文译文
目的：评价从动态碳-11蛋氨酸（C-11 MET）正电子发射断层成像/计算机断层成像（PET/CT）中提取的影像组学特征和最大标准化摄取值（SUVmax）在鉴别恶性与良性肌肉骨骼病变（MSLs）中的诊断效能，并将其性能与磁共振（MR）图像中的表观扩散系数（ADC）值进行比较。方法：本回顾性研究纳入15例伴有MSLs的患者（恶性7例，良性8例），患者均接受动态C-11 MET PET扫描[注射C-11 MET后5-15分钟（第1期）、15-25分钟（第2期）和25-35分钟（第3期）]及常规采集（注射后35分钟）。为对MET摄取进行半定量分析，我们使用SUVmax。为进行影像组学分析，从每个动态期整个目标肿瘤的感兴趣体积中提取109个特征。ADC值从MR图像中测量。诊断能力采用Mann-Whitney U检验和受试者工作特征曲线分析进行分析。结果：恶性组各动态期及常规采集的SUVmax均显著高于良性组（P < 0.05）。在影像组学分析中，第1期、第2期和第3期分别有70个、69个和69个特征在恶性组与良性组之间差异有统计学意义[P < 0.05；ROC曲线下面积（AUC）≥ 0.821]。DeLong检验显示，各动态期中SUVmax与任何影像组学特征之间的AUC均无显著差异。恶性组与良性组之间ADC值无显著差异。结论：动态 C-11 MET PET/CT 具有区分恶性和良性 MSL 的潜力，并支持放射组学分析和 SUVmax 的实用性。
完整摘要 · 英文原文
OBJECTIVE: To evaluate the diagnostic performance of radiomics features and maximum standardized uptake value (SUVmax) extracted from dynamic carbon-11 methionine (C-11 MET) PET/computed tomography (PET/CT) in differentiating malignant from benign musculoskeletal lesions (MSLs) and compare their performance with apparent diffusion coefficient (ADC) values from magnetic resonance (MR) images. METHODS: This retrospective study included 15 patients (malignant: seven and benign: eight) with MSLs who underwent dynamic C-11 MET PET scans [5-15 (phase 1), 15-25 (phase 2), and 25-35 (phase 3) min postinjection of C-11 MET] and conventional acquisition (35 min postinjection). For semiquantitative analysis of MET uptake, we used SUVmax. For radiomics analysis, 109 features were extracted from the volume of interest for the entire target tumor in each dynamic phase. ADC values were measured from MR images. Diagnostic capacities were analyzed using the Mann-Whitney U test and receiver operating characteristic curve analyses. RESULTS: SUVmax for each dynamic phase and conventional acquisition was significantly higher in the malignant group than in the benign group (P < 0.05). In radiomics analysis, 70, 69, and 69 features in phases 1, 2, and 3, respectively, were significantly different between malignant and benign groups [P < 0.05; area under the ROC curves (AUCs) ≥ 0.821]. DeLong's test showed no significant difference in AUCs between SUVmax and any radiomics feature in each dynamic phase. ADC values did not differ significantly between malignant and benign groups. CONCLUSION: Dynamic C-11 MET PET/CT has potential for differentiating malignant from benign MSLs and supports the utility of radiomics analyses and SUVmax.