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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) The value of PET/CT radiomic texture analysis of primary mass and mediastinal ly...
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Vol. 43. Issue 5.
(September - October 2024)
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Vol. 43. Issue 5.
(September - October 2024)
Original Article
The value of PET/CT radiomic texture analysis of primary mass and mediastinal lymph node on survival in patients with non-small cell lung cancer
N. Agüloğlua,
Corresponding author
aguloglunursin@gmail.com

Corresponding author.
, A. Aksub, D.S. Unatc, Ö. Selim Unatc
a Department of Nuclear Medicine, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
b Department of Nuclear Medicine, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Turkey
c Giresun Dr. Ali Menekşe Chest Diseases Hospital, Giresun, Turkey
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Figures (2)
Tables (3)
Table 1. Definition of parameters evaluated including conventional and advanced metabolic indices, shape features and radiomic texture features.
Table 2. Radiomic features of primary and lymph node PET in predicting survival.
Table 3. Radiomic features of primary and lymph node PET in predicting PFS.
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Abstract
Objective

This study was designed to determine the potential prognostic value of radiomic texture analysis and metabolic-volumetric parameters obtained from positron emission tomography (PET) in primary mass and metastatic hilar/mediastinal lymph nodes in stage 2–3 non-small cell lung cancer (NSCLC).

Methods

Images of patients diagnosed with stage 2–3 NSCLC who underwent 18F-FDG PET/CT imaging for staging up to 4 weeks before the start of treatment were evaluated using LIFEx software. Volume of interest (VOI) was generated from the primary tumor and metastatic lymph node separately, and volumetric and textural features were obtained from these VOIs. The relationship between the parameters obtained from PET of primary mass and the metastatic hilar/mediastinal lymph nodes with overall survival (OS) and progression-free survival (PFS) was analyzed.

Results

When radiomic features, gender and stage obtained from lymph nodes were evaluated by Cox regression analysis; GLCM_correlation (p: 0.033, HR: 4,559, 1.660–12.521, 95% CI), gender and stage were determined as prognostic factors predicting OS. In predicting PFS; stage, smoking and lymph node MTV (p: 0.033, HR: 1.008, 1.001–1.016, 95% CI) were determined as prognostic factors. However, the radiomic feature of the primary tumor could not show a significant relationship with either OS or PFS.

Conclusions

In a retrospective cohort of NSCLC patients with Stage 2 and 3 disease, volumetric and radiomic texture characteristics obtained from metastatic lymph nodes were associated with PFS and OS. Tumor heterogeneity, defined by radiomic texture features of 18 F-FDG PET/CT images, may provide complementary prognostic value in NSCLC.

Keywords:
18F-FDG PET/CT
NSCLC
Radiomic
Progression-free survival
Overall survival
Resumen
Objetivo

Este estudio fue diseñado para determinar el potencial valor pronóstico del análisis de textura radiómica y los parámetros metabólico-volumétricos obtenidos de la tomografía por emisión de positrones (PET) en masa primaria y adenopatías hiliomediastínicas metastásicas en el cáncer de pulmón de células no pequeñas (CPCNP) en estadio 2-3.

Métodos

Se evaluaron las imágenes de pacientes diagnosticados con CPCNP en estadio 2-3 que se realizaron un estudio PET/TC con [18F]FDG para estadificación hasta 4 semanas antes del inicio del tratamiento mediante el software LIFEx. El volumen de interés (VOI) se generó a partir del tumor primario y el ganglio linfático metastásico por separado, y las características volumétricas y texturales se obtuvieron a partir de estos VOI. Se analizó la relación entre los parámetros obtenidos de la PET de masa primaria y los ganglios linfáticos hiliomediastínicos metastásicos con la supervivencia global (OS) y la supervivencia libre de progresión (PFS).

Resultados

Cuando las características radiómicas, el sexo y el estadio obtenidos de las adenopatías se evaluaron mediante análisis de regresión de Cox; GLCM_correlación (p: 0,033, HR: 4.559, 1,660-12,521, IC 95%), el sexo y el estadio se determinaron como factores pronósticos de OS. En la predicción de la PFS; se determinaron como factores pronósticos el tabaquismo, el tabaquismo y el MTV ganglionar (p: 0,033, HR: 1,008, 1,001-1,016, IC 95%). Sin embargo, la característica radiómica del tumor primario no pudo mostrar una relación significativa con la OS ni con la PFS.

Conclusiones

En una cohorte retrospectiva de pacientes con CPCNP con enfermedad en estadios 2 y 3, las características volumétricas y de textura radiómica obtenidas de las adenopatías metastásicas se asociaron con la PFS y OS. La heterogeneidad tumoral, definida por las características de textura radiómica de las imágenes de PET/TC con [18F]FDG, puede proporcionar valor pronóstico complementario en el CPCNP.

Palabras clave:
PET/TC con [18F]FDG
CPCNP
Radiómica
Supervivencia libre de progresión
Supervivencia global

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