目的:本研究旨在确定2-3期非小细胞肺癌(NSCLC)原发肿块和转移性肺门/纵隔淋巴结正电子发射断层扫描(PET)的影像学纹理分析和代谢体积参数的潜在预后价值。
方法:使用LIFEx软件评估在治疗开始前4周接受18F-FDGPET/CT显像的2-3期NSCLC患者的图像。目的体积(VOI)分别从原发肿瘤和转移淋巴结产生,从这些VOI获得体积和纹理特征。分析了从原发性肿块的PET获得的参数与转移性肺门/纵隔淋巴结与总生存期(OS)和无进展生存期(PFS)之间的关系。
结果:当放射学特征时,通过Cox回归分析评估从淋巴结获得的性别和分期;GLCM相关性(p:0.033,HR:4,559,1.660-12.521,95%CI),性别和分期被确定为预测OS的预后因素.在预测PFS时;阶段,吸烟和淋巴结MTV(p:0.033,HR:1.008,1.001-1.016,95%CI)被确定为预后因素。然而,原发性肿瘤的影像学特征与OS或PFS均无显著关系.
结论:在2期和3期NSCLC患者的回顾性队列中,从转移性淋巴结获得的体积和影像纹理特征与PFS和OS相关.肿瘤异质性,由18个F-FDGPET/CT图像的放射学纹理特征定义,可能在NSCLC中提供互补的预后价值。
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.