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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Texture features of primary tumor on 18F-FDG PET images in non-small cell lung c...
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Vol. 40. Issue 6.
Pages 343-350 (November - December 2021)
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Vol. 40. Issue 6.
Pages 343-350 (November - December 2021)
Original Article
Texture features of primary tumor on 18F-FDG PET images in non-small cell lung cancer: The relationship between imaging and histopathological parameters
Características de textura del tumor primario en imágenes de 18F-FDG pet en cáncer de pulmón de células no pequeñas: la relación entre parámetros de imágenes y parámetros histopatológicos
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Uğuray Aydosa,
Corresponding author
uguray23@gmail.com

Corresponding author.
, Emel Rodoplu Ünalb, Mahsun Özçelikc, Deniz Akdemird, Özgür Ekincib, Abdullah İrfan Taştepee, Leyla Memişb, Lütfiye Özlem Ataya, Ümit Özgür Akdemira
a Gazi University, Faculty of Medicine, Department of Nuclear Medicine, Beşevler/Ankara, Turkey
b Gazi University, Faculty of Medicine, Department of Pathology, Beşevler/Ankara, Turkey
c Yüzüncü Yıl University, Faculty of Medicine, Department of Nuclear Medicine, Van, Turkey
d Michigan State University, Department of Epidemiology and Biostatistics, East Lansing, MI, USA
e Gazi University, Faculty of Medicine, Department of Thoracic Surgery, Beşevler/Ankara, Turkey
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Tables (4)
Table 1. The relationship between tumor types, histopathological variables and imaging parameters (n=90).
Table 2. The relationship between tumor subgroups, histopathological variables, PET/CT derived parameters and texture features in adenocarcinoma (n=44).
Table 3. The relationship between TNM stage categories, histopathological variables, PET/CT derived parameters and texture features (n=90).
Table 4. Results of univariate and multivariate regression analyses for prediction of the presence of mediastinal lymph node metastasis.
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Abstract
Purpose

The aims of this study were to evaluate the relationships between textural features of the primary tumor on FDG PET images and clinical-histopathological parameters which are useful in predicting prognosis in newly diagnosed non-small cell lung cancer (NSCLC) patients.

Methods

PET/CT images of ninety (90) patients with NSCLC prior to surgery were analyzed retrospectively. All patients had resectable tumors. From the images we acquired data related to metabolism (SUVmax, MTV, TLG) and texture features of primary tumors. Histopathological tumor types and subgroups, degree of Ki-67 expression and necrosis rates of the primary tumor, mediastinal lymph node (MLN) status and nodal stages were recorded.

Results

Among the two histologic tumor types (adenocarcinoma and squamous cell carcinoma) significant differences were present regarding metabolic parameters, Ki-67 index with higher values and kurtosis with lower values in the latter group. Textural heterogeneity was found to be higher in poorly differentiated tumors compared to moderately differentiated tumors in patients with adenocarcinoma. While Ki-67 index had significant correlations with metabolic parameters and kurtosis, tumor necrosis rate was only significantly correlated with textural features. By univariate and multivariate analyses of the imaging and histopathological factors examined, only gradient variance was significant predictive factor for the presence of MLN metastasis.

Conclusions

Textural features had significant associations with histologic tumor types, degree of pathological differentiation, tumor proliferation and necrosis rates. Texture analysis has potential to differentiate tumor types and subtypes and to predict MLN metastasis in patients with NSCLC.

Keywords:
Non-small cell lung cancer
F18 FDG
PET/CT
Texture analysis
Tumor heterogeneity
Resumen
Objetivos

En este estudio evaluamos las relaciones entre las características texturales de los tumores primarios en las imágenes PET-FDG y los parámetros clínico-histopatológicos. Estos parámetros son útiles para predecir el pronóstico de nuevos pacientes diagnosticados con cáncer de pulmón de células no pequeñas (CPCNP).

Materiales y Métodos

Las imágenes PET/TC de noventa (90) pacientes con CPCNP antes de la cirugía se analizaron retrospectivamente. Todos los pacientes tenían tumores resecables. De las imágenes adquirimos datos relacionados con el metabolismo (SUVmax, MTV, TLG) y las características de textura de los tumores primarios. Se registraron los tipos y subgrupos de tumores histopatológicos, el grado de expresión de Ki-67 y las tasas de necrosis del tumor primario, el estado de los ganglios linfáticos mediastínicos (MLN) y las etapas nodales.

Resultados

Entre los dos tipos de tumores histológicos (adenocarcinoma y carcinoma de células escamosas) hubo diferencias significativas con respecto a los parámetros metabólicos, el índice Ki-67 con valores más altos y la curtosis con valores más bajos en el último grupo. Se encontró que la heterogeneidad textural es mayor en los tumores poco diferenciados en comparación con los tumores moderadamente diferenciados en pacientes con adenocarcinoma. Mientras que el índice Ki-67 tenía correlaciones significativas con los parámetros metabólicos y la curtosis, la tasa de necrosis tumoral solo se correlacionó significativamente con las características de textura. Mediante análisis univariados y multivariados de los factores de imágen y los factores histopatológicos examinados, solo la variación del gradiente fue un factor predictivo significativo para la presencia de metástasis MLN.

Conclusión

Las características de textura tenían asociaciones significativas con los tipos de tumores histológicos, el grado de diferenciación patológica, la proliferación tumoral y las tasas de necrosis. El análisis de textura tiene el potencial de diferenciar los tipos y subtipos de tumores y predecir la metástasis de MLN en pacientes con CPCNP.

Palabras clave:
Cáncer de pulmón de células no pequeñas
F18 FDG
PET/TC
Análisis de textura
Heterogeneidad tumoral

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