Background This study aimed at assessing the prognostic value of textural indices extracted from 18F‐fluorodeoxyglucose positron‐emission tomography (FDG‐PET)/CT in a large cohort of patients with head and neck squamous cell carcinomas (HNSCC) of any anatomic subsite and staging. Methods Consecutive patients with HNSCC referred for a pretreatment FDG‐PET/CT were retrospectively included and followed up for a minimum of 2 years. Standardized uptake value, metabolic tumor volume (MTV), and textural indices were calculated using LIFEx software. Prognostic significance of parameters was assessed in univariate and multivariate analysis. Results Textural indices were extracted in 284 patients (mean age = 63.7±9.6 years). In univariate analysis, MTV and 4 textural indices—Correlation, Entropy, Energy, and Coarseness—were significantly correlated with overall survival (OS). In multivariate analysis, MTV (P = .008) and Correlation (P = .028) remained independently correlated to OS. Conclusion This study showed that MTV and 1 textural index extracted from pretherapeutic FDG‐PET/CT (Correlation) were independent prognostic factors of OS in patients with HNSCC.
Aim Characterizing tumor heterogeneity with textural indices extracted from 18F-fluorodeoxyglucose positron emission tomography (FDG PET/CT) is of growing interest in oncology. Several series showed promising results to predict survival in patients with head and neck squamous cell carcinoma (HNSCC), analyzing various tumor segmentation methods and textural indices. This preliminary study aimed at assessing the inter-observer and inter-segmentation method variability of textural indices in HNSCC pre-therapeutic FDG PET/CT. Materials and methods Consecutive patients with HNSCC referred in our department for a pre-therapeutic FDG PET/CT from January to March 2016 were retrospectively included. Two nuclear medicine physicians separately segmented all tumors using 3 different segmentation methods: a relative standardized uptake value (SUV) threshold (40%SUVmax), a signal-to-noise adaptive SUV threshold (DAISNE) and an image gradient-based method (PET-EDGE). SUV and metabolic tumor volume were recorded. Thirty-one textural indices were calculated using LIFEx software ( www.lifexsoft.org ). After correlation analysis, selected indices’ inter-segmentation method and inter-observer variability were calculated. Results Forty-three patients (mean age 63.8±9.3y) were analyzed. Due to a too small segmented tumor volume of interest, textural analysis could not be performed in 6, 11 and 15 cases with respectively DAISNE, 40%SUVmax and PET-EDGE segmentation methods. Five independent textural indices were selected (Homogeneity, Correlation, Entropy, Busyness and LZLGE). There was a high inter-contouring method variability for Homogeneity, Correlation, Entropy and LZLGE (p<0.0001 for each index). The inter-observer reproducibility analysis revealed an excellent agreement for 3 indices (Homogeneity, Correlation and Entropy) with an intraclass correlation coefficient higher than 0.90 for the 3 methods. Conclusions This preliminary study showed a high variability of 4 out of 5 textural indices (Homogeneity, Correlation, Entropy and LZLGE) extracted from pre-therapeutic FDG PET/CT in HNSCC using 3 different contouring methods. However, for each method, there was an excellent agreement between observers for 3 of these textural indices (Homogeneity, Correlation and Entropy).
Résumé -Introduction :La pycnodysostose est une maladie osseuse autosomique récessive, dont la prévalence est de 1/1,7 million. Elle se caractérise cliniquement par un nanisme, une ostéosclérose diffuse, une acro-ostéolyse des phalanges distales et une fragilité osseuse avec des fractures. La pycnodysostose présente des spécificités maxillo-faciales : une hypoplasie maxillaire et mandibulaire ainsi que des retards d'éruption dentaire. Observations : Les observations de deux patients atteints de pycnodysostose qui présentaient des complications maxillo-faciales caractéristiques de cette maladie sont rapportées et discutées. Les deux patients ont bénéficié d'une prise en charge en milieu hospitalier. Le premier patient souffrait d'une ostéomyélite maxillaire et mandibulaire. Le deuxième patient présentait des fractures mandibulaires pathologiques. Discussion : Ces observations sont ensuite comparées à celles retrouvées dans la littérature. La pycnodysostose est une maladie osseuse sclérosante due à une mutation du gène de la cathepsine K. La conséquence est une fragilité osseuse associée à de nombreuses fractures et ostéites identiques à celles des deux observations rapportées. Conclusion : Le patient atteint de pycnodysostose doit faire l'objet de soins dentaires réguliers pour éviter les complications osseuses et les avulsions dentaires, d'autant que la réhabilitation est compliquée par la morphologie des maxillaires et la structure osseuse. Abstract -Maxillofacial complications in patients with pycnodysostosis: report of two cases and literature review. Introduction: Pycnodysostosis is a rare recessive autosomal bone disorder. The estimated prevalence is 1 to 1.7 per million. The typical features of pycnodysostosis include short stature, diffuse osteosclerosis, acroosteolysis of the distal phalanges and brittle bones. Maxillofacial features are midfacial and mandibular hypoplasia, and delayed teeth eruption. Observations: Two clinical cases of pycnodysostosis with typical maxillofacial complications are presented. Each patient was treated at a hospital. The first patient suffered from maxillary and mandibular osteomyelitis, and the other had a mandibular pathological fracture. Discussion: These observations are compared with previous cases reported in the literature. Pycnodysostosis is a sclerosing bone disorder caused by deficiency of the cathepsin enzyme K. This causes brittle bones; pathological fractures and osteomyelitis are typical complications. Conclusion: Patients with pycnodysostosis need special dental care in order to avoid tooth extraction and bone complications. Moreover, dental prosthetic rehabilitation is difficult due to jaw morphology.
Poster Presentations P171yielded significantly larger medial pathology margins compared to the traditional method. This study is limited by the retrospective nature of the comparison group. A prospective trial should be undertaken to confirm these results.
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