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CT Texture Analysis in Patients with Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy : 국소진행성 직장암의 컴퓨터 단층 촬영 질감 특징 분석과 수술 전 화학 방사선 치료의 반응 평가 및 무질병 생존률과의 연관관계

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의과대학 임상의과학과
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서울대학교 대학원
texture analysislocally advanced rectal cancerneoadjuvant chemoradiotherapytreatment responsedisease free survival
학위논문 (석사)-- 서울대학교 대학원 : 임상의과학과, 2017. 2. 김영훈.
CT Texture Analysis in Patients with Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy
- A Potential Imaging Biomarker for Treatment Response and Prognosis -

Choong Guen Chee
Department of Clinical Medical Sciences
The Graduate School
Seoul National University

PURPOSE: To evaluate the association of computed tomography (CT) texture features of locally advanced rectal cancer with neoadjuvant chemoradiotherapy (CRT) response and disease-free survival (DFS).

MATERIALS AND METHODS: The institutional review board approved this retrospective study. 95 patients who received neoadjuvant CRT, followed by surgery, for locally advanced rectal cancer were included. Texture features (entropy, uniformity, kurtosis, skewness, and standard deviation) were assessed in pretreatment CT images and obtained without filtration and with Laplacian of Gaussian spatial filter of various filter values (1.0, 1.5, 2.0, and 2.5). Dworak pathologic grading was used for treatment response assessment. Independent t-test was used to compare each texture feature between the treatment responder and non-responder groups. DFS was assessed with Kaplan-Meier method, and differences were compared with log-rank test. Cox proportional hazards models were constructed to predict prognosis based on stage, age, and each texture feature.

RESULTS: Treatment responders (n = 32) showed significantly lower entropy, higher uniformity, and lower standard deviation in no filtration, fine (1.0), and medium (1.5) filter values. Entropy, uniformity, and standard deviation without filtration showed significant difference in DFS in Kaplan-Meier analysis (P = 0.015, 0.025, and 0.038). Homogeneous texture features (≤ 6.7 for entropy, > 0.0118 for uniformity, and ≤ 28.06 for standard deviation) were associated with higher DFS. Entropy, uniformity, and standard deviation were independent texture features in predicting DFS (P = 0.017, 0.03, and 0.036)

CONCLUSION: Homogeneous texture features are associated with better neoadjuvant CRT response and higher DFS in patients with locally advanced rectal cancer.

keywords : texture analysis, locally advanced rectal cancer, neoadjuvant chemoradiotherapy, treatment response, disease free survival

Student Number : 2015-22262
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