대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제83권1호
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  • Pages.112-126
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  • 2022
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  • 1738-2637(pISSN)
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  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
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연조직 육종의 종양 가장자리 침윤: 3T 자기공명영상 텍스처 분석을 통한 예측

Tumor Margin Infiltration in Soft Tissue Sarcomas: Prediction Using 3T MRI Texture Analysis

  • 김민지 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 지원희 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 이영준 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 홍지현 (한림대학교 의과대학 강동성심병원 영상의학과) ;
  • 정찬권 (가톨릭대학교 의과대학 서울성모병원 병리과) ;
  • 정양국 (가톨릭대학교 의과대학 서울성모병원 정형외과) ;
  • 이소연 (가톨릭대학교 의과대학 서울성모병원 영상의학과)
  • Minji Kim (Department of 1Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Won-Hee Jee (Department of 1Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Youngjun Lee (Department of 1Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Ji Hyun Hong (Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine) ;
  • Chan Kwon Jung (Department of Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Yang-Guk Chung (Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • So-Yeon Lee (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 투고 : 2021.02.23
  • 심사 : 2021.05.11
  • 발행 : 2022.01.01
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초록

목적 연조직 육종의 종양 가장자리 침윤을 예측하기 위한 3T 자기공명영상 텍스처 분석의 가치를 규명한다. 대상과 방법 3T 자기공명영상을 시행하고, 병리학적으로 연조직 육종으로 확인된 31명의 환자를 대상으로 하고, 병리학적인 가장자리 침윤을 표준으로 사용하였다. 연조직 육종에 대한 텍스처 분석은 축상 T1 강조영상, T2 강조영상, 지방억제 조영증강 T1 강조영상, 확산강조영상(b = 800 sec/mm2) 및 현성확산계수 지도 영상에서 이루어졌다. 텍스처 분석에서 얻어진 정량적 변수가 침윤성(infiltrative) 육종과 국한성(circumscribed) 육종에서 차이가 있는지 비교하였다. 결과 총 23명의 연조직 육종에서 병리학적인 가장자리 침윤을 보였다. 침윤성 육종과 국한성 육종은, T1 강조영상 공간 스케일 인자(spatial scaling factor; 이하 SSF) 0, 6에서의 첨도(kurtosis), 조영증강 T1 강조영상(SSF, 0)에서의 첨도, 확산강조영상(SSF, 0)에서의 왜도(skewness), 현성확산계수 지도(SSF 2, 4)에서의 왜도에서 유의한 차이가 있었다(p ≤ 0.046). 자기공명영상 텍스처 소견을 이용한 종양 가장자리 침윤을 예측하는 정확도는 수신자운영특성곡선(receiver operating characteristic; 이하 ROC)의 곡선하 면적(area under the ROC curve) 0.951 (p < 0.001)이었다. 결론 자기공명영상 텍스처 분석은 연조직 육종의 침윤성 가장자리를 예측하는 데 있어 신뢰 할 수 있으며 정확하다.

Purpose To determine the value of 3 Tesla (T) MRI texture analysis for predicting tumor margin infiltration in soft tissue sarcomas. Materials and Methods Thirty-one patients who underwent 3T MRI and had a pathologically confirmed diagnosis of soft tissue sarcoma were included in this study. Margin infiltration on pathology was used as the gold standard. Texture analysis of soft tissue sarcomas was performed on axial T1-weighted images (WI) and T2WI, fat-suppressed contrast-enhanced (CE) T1WI, diffusion-weighted images (DWI) with b-value of 800 s/mm2, and apparent diffusion coefficient (ADC) was mapped. Quantitative parameters were compared between sarcomas with infiltrative margins and those with circumscribed margins. Results Among the 31 patients with soft tissue sarcomas, 23 showed tumor margin infiltration on pathology. There were significant differences in kurtosis with the spatial scaling factor (SSF) of 0 and 6 on T1WI, kurtosis (SSF, 0) on CE-T1WI, skewness (SSF, 0) on DWI, and skewness (SSF, 2, 4) on ADC between sarcomas with infiltrative margins and those with circumscribed margins (p ≤ 0.046). The area under the receiver operating characteristic curve based on MR texture features for identification of infiltrative tumor margins was 0.951 (p < 0.001). Conclusion MR texture analysis is reliable and accurate for the prediction of infiltrative margins of soft tissue sarcomas.

키워드

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