The Application Value Of CT Texture Analysis In Cervical Lymph Node Metastasis Of Hypopharyngeal Carcinoma

Objective: In this study,the method of CT texture analysis was used to extract the characteristic information from the CT-enhanced image of the neck of the primary tumor lesions,to predicting the feasibility cervical lymph node metastasis in patients with hypopharyngeal carcinoma before operation.Provide new ideas and new methods for preoperative examination and diagnosis of patients with hypopharyngeal cancer.Methods:1The clinical information of 42 patients with hypopharyngeal cancer diagnosed and treated in Subei People’s Hospital between 2015.01-2020.10 were selected and collected.Screening enrolled patients: All patients in the group underwent surgical treatment within 1 month after CT examination.No radiotherapy or chemotherapy was performed before the CT examination.All patients underwent cervical lymph node dissection.According to the accurate pathological p TMN staging provided by the post-operative pathology,and no lymph node metastasis or primary tumor recurrence occurred in the follow-up 6 months after surgery,a total of 33 patients were enrolled in the study.The postoperative pathological examination results of the two groups of patients were used as the basis for grouping,including pN0 13 cases,pN112 cases,and pN2 8 cases.They were further divided into the non-lymph node metastasis group,namely pN0(n=13)and the lymph node metastasis group,namely pN+(n=20).2.Acquire CT enhanced images of neck,and collect two images of the patient’s arterial phase and venous phase showing the largest level of the lesion.All images are segmented by professional rendering software.Use Ma Zda4.6 software to manually delineate the Region of interest(ROI)on the patient’s neck CT enhanced image.Use software to extract texture parameters,and extract 5 texture parameters with reference value: Mean value,Skewness,Correlation,Entropy and Kurtosis.Compare the difference of the texture parameter values on the venous phase and arterial phase of the cervical CT enhancement between the two groups of patients,and perform statistical analysis on the values of the extracted texture parameters.Draw statistically different texture parameter values through receiver operator characteristic(,ROC).Calculate area underthe ROC curve(AUC),judge diagnostic efficiency analysis,calculate Sensitivity and Specificity.Result:1.Difference test: In the pN0 group and pN+ group,P=0.567 for the age of patients,and P=0.614 for the T stage.Therefore,both age and T stage are not statistically significant in the statistics of the two groups(P> 0.05).The p-values of the Mean value,Skewness,and Kurtosis of the vein phase texture analysis values of the pN0 group and pN+ group were 0.652,0.205,and 0.611,and the p-values of the Mean value,Skewness,and Kurtosis of the arterial phase were 0.985,0.5000,0.321,all greater than 0.05,so it is considered that there is no statistical difference in the Mean value,Skewness and Kurtosis between the pN0 group and the pN+ group.The P-value of the venous phase correlation between the pN0 group and the pN+ group is 0.004 and less than 0.005;the P value of the arterial phase correlation between the pN0 group and the pN+ group is0.004 and less than 0.005,the Correlation between the two groups is statistically different.The P-values of the entropy values of the arterial phase and the venous phase between the pN0 group and the pN+ group were less than 0.001,There are significant statistical differences in Entropy between the two groups.Select the texture analysis value with statistical difference to draw ROC curve and judge its diagnostic energy efficiency.2.In the venous phase,Entropy AUC=0.858 Correlation AUC=0.804,the value of AUC is between 0.7-0.9,In the arterial phase,the Entropy AUC=0.877 Correlation AUC=0.785,and the value of AUC is between 0.7-0.9.Therefore,the value of Entropy and the value of Correlation have certain accuracy in judging cervical lymph node metastasis of hypopharyngeal cancer.Conclusion:The Entropy value and Correlation value in the texture parameter can be used to distinguish tumor heterogeneity and other characteristics to predict and judge the neck lymph node metastasis.The Entropy of texture parameters in the venous phase and the Entropy of texture parameters in the arterial phase can be used as independent predictors its sensitivity and specificity have good performance.The texture analysis method can provide new methods and ideas for judging the status of lymph node metastasis before clinical operation.