대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제82권2호
  • /
  • Pages.406-416
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  • 2021
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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원발성 비점액성 직장암 환자에서 자기공명영상 기반 텍스처 분석 변수와 KRAS 유전자 변이와의 연관성

Association between Texture Analysis Parameters and Molecular Biologic KRAS Mutation in Non-Mucinous Rectal Cancer

  • 조성재 (인제대학교 의과대학 해운대백병원 영상의학과) ;
  • 김승호 (인제대학교 의과대학 해운대백병원 영상의학과) ;
  • 박상준 (서울대학교병원 영상의학과) ;
  • 이예다운 (인제대학교 의과대학 해운대백병원 영상의학과) ;
  • 손정희 (인제대학교 의과대학 해운대백병원 영상의학과)
  • Sung Jae Jo (Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital) ;
  • Seung Ho Kim (Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital) ;
  • Sang Joon Park (Department of Radiology, Seoul National University Hospital) ;
  • Yedaun Lee (Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital) ;
  • Jung Hee Son (Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital)
  • 투고 : 2020.04.06
  • 심사 : 2020.06.23
  • 발행 : 2021.03.01
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초록

목적 원발성 비점액성 직장암 환자에서 자기공명영상 기반 텍스처 분석 변수와 Kirsten rat sarcoma viral oncogene homolog (이하 KRAS) 유전자 변이와의 연관성을 조사한다. 방법 조직학적으로 비점액성 직장 선암종으로 진단받고 KRAS 유전자 정보가 있으며 치료 전 직장 자기공명영상을 시행한 79명의 환자를 훈련 데이터셋(n = 46)과 검증 데이터셋(n = 33)으로 나누었다. 텍스처 분석은 축상면 T2 강조영상에서 시행되었다. 텍스처 변수와 KRAS 유전자 변이와의 연관성은 Mann-Whitney U 검정을 통해 통계적으로 분석하였다. 수신기작동 특성 곡선(receiver operating characteristic) 분석을 이용하여 KRAS 유전자 변이를 예측하기 위한 최적의 절단값을 산출하였다. 이 절단값은 검증 데이터셋을 사용해 검증되었다. 결과 훈련 데이터셋에서 왜도(skewness)는 유전자 변이가 있는 집단(n = 22명)에서 유전자 변이가 없는 집단(n = 24명)보다 유의하게 높았다(0.221 ± 0.283; -0.006 ± 0.178, p = 0.003). 왜도의 곡선 하 면적 값(area under the curve)은 0.757 (95% 신뢰구간, 0.606-0.872)로 정확도는 71%, 민감도는 64%, 특이도는 78%였다. 다른 텍스처 변수들은 두 집단 간 유의한 차이를 보이지 않았다(p > 0.05). 검증 데이터셋에 절단값 0.078을 적용하였을 때 정확도는 76%, 민감도는 86%, 특이도는 68%였다. 결론 원발성 비점액성 직장암 환자에서 왜도는 KRAS 유전자 변이와 연관성을 보였다.

Purpose To evaluate the association between magnetic resonance imaging (MRI)-based texture parameters and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation in patients with non-mucinous rectal cancer. Materials and Methods Seventy-nine patients who had pathologically confirmed rectal non-mucinous adenocarcinoma with or without KRAS-mutation and had undergone rectal MRI were divided into a training (n = 46) and validation dataset (n = 33). A texture analysis was performed on the axial T2-weighted images. The association was statistically analyzed using the Mann-Whitney U test. To extract an optimal cut-off value for the prediction of KRAS mutation, a receiver operating characteristic curve analysis was performed. The cut-off value was verified using the validation dataset. Results In the training dataset, skewness in the mutant group (n = 22) was significantly higher than in the wild-type group (n = 24) (0.221 ± 0.283; -0.006 ± 0.178, respectively, p = 0.003). The area under the curve of the skewness was 0.757 (95% confidence interval, 0.606 to 0.872) with a maximum accuracy of 71%, a sensitivity of 64%, and a specificity of 78%. None of the other texture parameters were associated with KRAS mutation (p > 0.05). When a cut-off value of 0.078 was applied to the validation dataset, this had an accuracy of 76%, a sensitivity of 86%, and a specificity of 68%. Conclusion Skewness was associated with KRAS mutation in patients with non-mucinous rectal cancer.

키워드

과제정보

This work was supported by the 2019 Inje University research grant.

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