Kamil DOĞAN, Murat BAYKARA, Abdulkadir Yasir BAHAR, Müslüm ÖZGÜL

Kolokteral karsinomda histopatolojik düşük ve yüksek dereceli tümörlerin ayrımı için bilgisayarlı tomografi histogram analizinin tanısal etkinliği

Giriş ve amaç: Kolokteral adenokarsinom (KA), dünya çapında en yaygın kanser türüdür ve kansere bağlı ölümlerin üçüncü önde gelen nedenidir. Hastalığın seyrinde primer patolojik derece önem taşır. Radyoloji modaliteleri aracılığıyla non-invaziv derecelendirme olasılığı hala önemli bir konudur. Bu çalışma, bilgisayarlı tomografi (BT) tarama görüntülerinde histogram analizi kullanılarak patolojik derecelendirmeye benzer non-invaziv bir derecelendirmenin yapılıp yapılamayacağını ortaya koymayı amaçlamaktadır. Gereç ve Yöntem: Ameliyat edilen ve patolojik olarak KA tanısı alan 58 hasta bu çalışmaya dahil edildi. Medikal protokol olarak TOSHIBA Alexion ve TOSHIBA Aquilion ONE (Toshiba Medical Systems, Nasu, Japan) cihazlarından alınan 120 kVp tüp voltajı ile abdominal intravenöz kontrastlı BT görüntüleri pencere genişliği 400 ve pencere seviyesi 40 olarak ayarlandı. Retrospektif taramadan alınan görüntüler bir iş istasyonunda değerlendirildi. Kitle değerlendirmesi için intraluminal hava, nekrotik alanlar, perikolonik yağ dokusu veya kitle içi büyük besleyici damarlar ölçüm aralığına dahil edilmedi. Kütle boyutu en uzun eksene göre en büyük eksende ölçülmüştür. Histogram analizi için ilgi bölgeleri konumlandırıldı. Histogram analizine dahil edilen parametreler piksel, ortalama, standart sapma, minimum, maksimum, medyan, varyans, entropi, %L boyutu, %U boyutu, %M boyutu, basıklık, çarpıklık, tekdüzelik, yüzde01, yüzde03, yüzde05, yüzde10, yüzde25, yüzde75, yüzde90, yüzde95, yüzde97 ve yüzdelik dilim 99. Bulgular: 58 hastanın her biri için üç farklı ölçümden elde edilen histogram analiz sonuçları, patolojik olarak tanımlanan histolojik derecelendirme sisteminin farklılaşmasında istatistiksel olarak anlamlı bulunmadı. Sonuç: İnvaziv yerine invaziv olmayan bir yöntemin kullanılması avantaj sağlasa da histolojik derecenin tahmininde istatistiksel olarak anlamlı değildi.

Anahtar Kelimeler:

Kolokteral adenokarsinom, histogram analizi, bilgisayarlı tomografi, histolojik derece, doku analizi

Diagnostic efficacy of computed tomography histogram analysis for the differentiation of histopathological low- and high-grade tumors in colocteral carcinoma

Aim: Colorectal adenocarcinoma (CA) is the most common type of cancer worldwide and the third leading cause of cancer-related deaths. Primary pathological grade bears importance in the course of the disease. The possibility of non-invasive grading through radiology modalities is still an important issue. The present study aims to reveal whether a non-invasive grading similar to pathological grading can be performed using histogram analysis on computed tomography (CT) scan images. Material and Method: 58 patients operated and diagnosed with CA pathologically were included in the present study. As for medical protocol, abdominal intravenous contrast CT scan images obtained from TOSHIBA Alexion and TOSHIBA Aquilion ONE (Toshiba Medical Systems, Nasu, Japan) devices with 120 kVp tube voltage were set to a window width of 400 and a window level of 40. Patient images from retrospective scanning were evaluated on a workstation. For the evalution of mass, intraluminal air, necrotic areas, pericolonic fat tissue or intra-mass large feeding vessels were not included in the measurement range. Mass size was measured on the largest axis according to the longest axis. For histogram analysis, regions of interest were positioned. Parameters included in the histogram analysis were pixels, mean, standard deviation, minimum, maximum, median, variance, entropy, size L%, size U%, size M%, kurtosis, skewness, uniformity, percent01, percent03, percent05, percent10, percent25, percent75, percent90, percent95, percent97 and percentile 99. Results: Histogram analysis results obtained from three different measurements for each of 58 patients were not found to be statistically significant in the differentation of pathologically defined histological grading system. Conclusion: Although the use of a non-invasive method instead of an invasive one may offer an advantage, was not statistically significant in the prediction of histological grade.

Keywords:

Colorectal adenocarcinoma, Histogram analysis, Computed tomography, Histological grade, Texture analysis,

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