Radiomic Features of 18F-FDG PET in Hodgkin Lymphoma Are Predictive of Outcomes

Zhou, Yeye; Zhu, Ye; Chen, Zhiqiang; Li, Jihui; Sang, Shibiao; Deng, Shengming

doi:10.1155/2021/6347404

Cited by 18 publications

(22 citation statements)

References 46 publications

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“…In line with our results, a high D max predicted a shorter PFS and OS in DLBCL patients ( 30 , 34 ). It has also been reported that a high D max is a poor prognostic factor of HL ( 36 ). Unlike TMTV or TLG, which are derived from lesion contours, D max is calculated as the distance between two lesions that were furthest apart.…”

Section: Discussionmentioning

confidence: 93%

Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Wang

Fan

et al. 2022

Front. Oncol.

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PurposeWe investigated the utility of a new baseline PET parameter expressing lesion dissemination and metabolic parameters for predicting progression-free survival (PFS) and pathologic grade in follicular lymphoma (FL).MethodsThe baseline 18F-FDG PET/CT images of 126 patients with grade 1–3A FL were retrospectively analyzed. A novel PET/CT parameter characterizing lesion dissemination, the distance between two lesions that were furthest apart (Dmax), was calculated. The total metabolic tumor volume and total lesion glycolysis (TLG) were computed by using 41% of the maximum standardized uptake value (SUVmax) thresholding method.ResultsThe 5-year PFS rate was 51.9% for all patients. In the multivariate analysis, high Dmax [P = 0.046; hazard ratio (HR) = 2.877], high TLG (P = 0.004; HR = 3.612), and elevated serum lactate dehydrogenase (P = 0.041; HR = 2.287) were independent predictors of PFS. A scoring system for prognostic stratification was established based on these three adverse factors, and the patients were classified into three risk categories: low risk (zero to one factor, n = 75), intermediate risk (two adverse factors, n = 29), and high risk (three adverse factors, n = 22). Patients in the high-risk group had a shorter 3-year PFS (21.7%) than those in the low- and intermediate-risk groups (90.6 and 44.6%, respectively) (P < 0.001). The C-index of our scoring system for PFS (0.785) was superior to the predictive capability of the Follicular Lymphoma International Prognostic Index (FLIPI), FLIPI2, and PRIMA-Prognostic Index (C-index: 0.628–0.701). The receiver operating characteristic curves and decision curve analysis demonstrated that the scoring system had better differentiation and clinical utility than these existing indices. In addition, the median SUVmax was significantly higher in grade 3A (36 cases) than in grades 1 and 2 FL (90 cases) (median: 13.63 vs. 11.45, P = 0.013), but a substantial overlap existed (range: 2.25–39.62 vs. 3.17–39.80).ConclusionTLG and Dmax represent two complementary aspects of the disease, capturing the tumor burden and lesion dissemination. TLG and Dmax are promising metrics for identifying patients at a high risk of progression or relapse. Additionally, SUVmax seems to have some value for distinguishing grade 3A from low-grade FL but cannot substitute for biopsy.

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Section: Discussionmentioning

confidence: 93%

Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Wang

Fan

et al. 2022

Front. Oncol.

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“…A total of 24 articles on lymphomas were included in this review [ 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 ], 13 of which studying diffuse large B-cell lymphoma (including 2 studies on gastro-intestinal lymphoma), 3 on follicular lymphoma, 3 on Hodgkin’s lymphoma, 2 on mantle cell lymphoma and 3 on other sub-types of lymphoma. 18F-FDG was the only tracer employed and all studies built radiomic models on baseline, pre-treatment PET images, often including clinical parameters and international prognostic indices.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies evaluated the role of PET radiomics and AI analysis in blood malignancies [ 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 ]. Lymphoma radiomics on 18F-FDG PET/CT was more often assessed on patients with DLBCL, in retrospective cohorts and for prognostic purposes.…”

Section: Discussionmentioning

confidence: 99%

Radiomics in Oncological PET Imaging: A Systematic Review—Part 2, Infradiaphragmatic Cancers, Blood Malignancies, Melanoma and Musculoskeletal Cancers

et al. 2022

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The objective of this review was to summarize published radiomics studies dealing with infradiaphragmatic cancers, blood malignancies, melanoma, and musculoskeletal cancers, and assess their quality. PubMed database was searched from January 1990 to February 2022 for articles performing radiomics on PET imaging of at least 1 specified tumor type. Exclusion criteria includd: non-oncological studies; supradiaphragmatic tumors; reviews, comments, cases reports; phantom or animal studies; technical articles without a clinically oriented question; studies including <30 patients in the training cohort. The review database contained PMID, first author, year of publication, cancer type, number of patients, study design, independent validation cohort and objective. This database was completed twice by the same person; discrepant results were resolved by a third reading of the articles. A total of 162 studies met inclusion criteria; 61 (37.7%) studies included >100 patients, 13 (8.0%) were prospective and 61 (37.7%) used an independent validation set. The most represented cancers were esophagus, lymphoma, and cervical cancer (n = 24, n = 24 and n = 19 articles, respectively). Most studies focused on 18F-FDG, and prognostic and response to treatment objectives. Although radiomics and artificial intelligence are technically challenging, new contributions and guidelines help improving research quality over the years and pave the way toward personalized medicine.

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“…A recent study by Zhou and co-workers evaluated if the radiomic features of baseline FDG PET could predict the prognosis of Hodgkin lymphoma [39]. They found that Long-zone high gray-level emphasis and Dmax were independently correlated with 2-year progression-free survival.…”

Section: Discussionmentioning

confidence: 99%

“…Of those, 84% (n=72/88) achieved complete metabolic response (CMR) at end of therapy PET/CT de ned by Deauville score criteria below 4 [34][35][37][38][39][40]…”

mentioning

confidence: 99%

Combination of FDG PET/CT Radiomics and Clinical Parameters for Outcome Prediction in Patients with Hodgkin’s Lymphoma

Ortega

Eshet

Prica

et al. 2022

Preprint

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Purpose: The aim of the study is to evaluate the prognostic value of joint evaluation of PET- and CT radiomics combined with standard clinical parameters in patients with HL. Methods: Overall, 88 patients (42 female and 46 male) with a median age of 43.3 (range 21-85 years) were included. Textural analysis of the PET/CT images was performed using a freely available software (LIFE X). 65 radiomics features (RF) were evaluated. Univariate and Multivariate models were used to determine the value of clinical characteristics and FDG PET/CT radiomics in outcome prediction. A binary logistic regression model was used to determine potential predictors for radiotherapy and odds ratios (OR) with 95% confidence intervals (CI) were reported. Features relevant for survival outcome were assessed with Cox proportional hazards to calculate hazard ratios with 95% CI. Results: Overall, Albumin + ALP + CT radiomic features (Area under curve (AUC): 95.0 (86.9;100.0) – Brier: 3.9 (0.1;7.8) remained as significant independent predictors for outcome prediction. PET- SHAPE Sphericity (1.9 (1.05,3.42) p=0.033); CT grey level zone length matrix high gray-level zone emphasis (GLZLM SZHGE mean (2 (1.08,3.73) p=0.028)) and PARAMS XSpatial Resampling (2.1 (1.2,3.68) p=0.0091) as well as hemoglobin results (p=0.016) remained as independent features in the final model for binary outcome as predictors of need of radiotherapy. (AUC = 0.79) Conclusion: We evaluated the value of baseline clinical parameters as well as combined PET and CT radiomics in HL patients for survival and prediction of need of radiotherapy. We found that different combinations of all three factors/features were independently predictive of the here evaluated endpoints.

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Radiomic Features of 18F-FDG PET in Hodgkin Lymphoma Are Predictive of Outcomes

Cited by 18 publications

References 46 publications

Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Radiomics in Oncological PET Imaging: A Systematic Review—Part 2, Infradiaphragmatic Cancers, Blood Malignancies, Melanoma and Musculoskeletal Cancers

Combination of FDG PET/CT Radiomics and Clinical Parameters for Outcome Prediction in Patients with Hodgkin’s Lymphoma

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