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大腸癌肝転移切除患者の予後予測におけるMR画像特徴量抽出の有用性

山下, 博司 東京大学 DOI:10.15083/0002006959

2023.03.24

概要

[課程-2]
審査の結果の要旨
氏名山下

博司

本研究は大腸癌肝転移において radiomics の手法により肝切除術前に予後や病理所見の
予測を行ったものである。Radiomics とは医用画像から腫瘍の生物学的分子の詳細な特性
を明らかにしようという試みを指しており、本研究では下記の結果を得ている。
1. 予後予測については術前臨床因子のみからのモデルと radiomics 特徴量を用いて構
築した radiomics signature を加えたモデルを作成した。患者のセット分割や cross
validation によりそれぞれ 80 組のモデルを作成して、モデルから得られた C-index
を対応のある t 検定により比較した。全生存率、無再発生存率において有意差が得
られ、radiomics 特徴量が大腸癌肝転移の予後予測因子となり得ることが示され
た。
2. 病理所見については病理所見の予測モデルの結果は histological growth pattern に
おける線維性の被膜の割合を予測するモデルの予測値と実測値の間に弱い相関がみ
られた。粘液癌成分、胆管侵襲、門脈侵襲、肝静脈侵襲のにおいては予測モデルか
らは有意な結果を得ることができなかった。
以上、本研究は大腸癌肝転移の予後予測において radiomics の手法により、術前臨床因
子のみよりも予後を正確に予測しうることを示した。本研究は大腸癌肝転移の治療の進歩
に貢献をなすと考えられる。
よって本論文は博士(医 学 )の学位請求論文として合格と認められる。

この論文で使われている画像

参考文献

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9. 謝辞

本研究を施行するにあたりまして、御指導を賜りました東京大学大学院医学

系研究科生体物理医学専攻放射線診断学教授 阿部

修先生に厚く御礼申し上

げます。

研究計画の検討や、データの分析、論文の校閲など多岐にわたり、御指導、御尽力

いただきました東京大学医学部附属病院放射線診断学講師 花岡 昇平先生、助教

中井 雄大先生に厚く御礼申し上げます。

肝胆膵外科・人工臓器移植外科の長谷川

潔教授、有田

淳一先生、西岡

先生には貴重な症例データをお貸しいただき、病理部の牛久

裕次郎

哲男先生、阿部

幸先生には病理組織標本の再評価をしていただきました。厚く感謝を申し上げます。

73

...

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