Abstract:We assessed the predictive value of new radiomic features characterizing lesion dissemination in baseline 18 F-FDG PET and tested whether combining them with baseline metabolic tumor volume (MTV) could improve prediction of progression-free survival (PFS) and overall survival (OS) in diffuse large B-cell lymphoma (DLBCL) patients. Methods: From the LNH073B trial (NCT00498043), patients with advancedstage DLCBL and 18 F-FDG PET/CT images available for review were selected. MTV and several radiomic features, inc… Show more
“…Moreover, Aide et al [ 35 , 40 ] found that skewness of skeletal heterogeneity was a prognostic factor for PFS, and long-zone high gray level emphasis from GLSZM was a prognostic parameter for 2-year event-free survival. Recently, Cottereau et al [ 41 ] reported that the radiomic feature characterizing lesion dissemination was associated with PFS and OS. Our findings are in line with those of studies indicating that the PET-derived radiomic features are useful for patient outcome prognostication in DLBCL.…”
This study investigates whether baseline 18F-FDG PET radiomic features can predict survival outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively enrolled 83 patients diagnosed with DLBCL who underwent 18F-FDG PET scans before treatment. The patients were divided into the training cohort (n = 58) and the validation cohort (n = 25). Eighty radiomic features were extracted from the PET images for each patient. Least absolute shrinkage and selection operator regression were used to reduce the dimensionality within radiomic features. Cox proportional hazards model was used to determine the prognostic factors for progression-free survival (PFS) and overall survival (OS). A prognostic stratification model was built in the training cohort and validated in the validation cohort using Kaplan–Meier survival analysis. In the training cohort, run length non-uniformity (RLN), extracted from a gray level run length matrix (GLRLM), was independently associated with PFS (hazard ratio (HR) = 15.7, p = 0.007) and OS (HR = 8.64, p = 0.040). The International Prognostic Index was an independent prognostic factor for OS (HR = 2.63, p = 0.049). A prognostic stratification model was devised based on both risk factors, which allowed identification of three risk groups for PFS and OS in the training (p < 0.001 and p < 0.001) and validation (p < 0.001 and p = 0.020) cohorts. Our results indicate that the baseline 18F-FDG PET radiomic feature, RLNGLRLM, is an independent prognostic factor for survival outcomes. Furthermore, we propose a prognostic stratification model that may enable tailored therapeutic strategies for patients with DLBCL.
“…Moreover, Aide et al [ 35 , 40 ] found that skewness of skeletal heterogeneity was a prognostic factor for PFS, and long-zone high gray level emphasis from GLSZM was a prognostic parameter for 2-year event-free survival. Recently, Cottereau et al [ 41 ] reported that the radiomic feature characterizing lesion dissemination was associated with PFS and OS. Our findings are in line with those of studies indicating that the PET-derived radiomic features are useful for patient outcome prognostication in DLBCL.…”
This study investigates whether baseline 18F-FDG PET radiomic features can predict survival outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively enrolled 83 patients diagnosed with DLBCL who underwent 18F-FDG PET scans before treatment. The patients were divided into the training cohort (n = 58) and the validation cohort (n = 25). Eighty radiomic features were extracted from the PET images for each patient. Least absolute shrinkage and selection operator regression were used to reduce the dimensionality within radiomic features. Cox proportional hazards model was used to determine the prognostic factors for progression-free survival (PFS) and overall survival (OS). A prognostic stratification model was built in the training cohort and validated in the validation cohort using Kaplan–Meier survival analysis. In the training cohort, run length non-uniformity (RLN), extracted from a gray level run length matrix (GLRLM), was independently associated with PFS (hazard ratio (HR) = 15.7, p = 0.007) and OS (HR = 8.64, p = 0.040). The International Prognostic Index was an independent prognostic factor for OS (HR = 2.63, p = 0.049). A prognostic stratification model was devised based on both risk factors, which allowed identification of three risk groups for PFS and OS in the training (p < 0.001 and p < 0.001) and validation (p < 0.001 and p = 0.020) cohorts. Our results indicate that the baseline 18F-FDG PET radiomic feature, RLNGLRLM, is an independent prognostic factor for survival outcomes. Furthermore, we propose a prognostic stratification model that may enable tailored therapeutic strategies for patients with DLBCL.
“…A study by Vercellino and colleagues found high pretreatment MTV to be significantly associated with inferior PFS and OS in this group [75]. Including patients from the LNH073B study, a French working group additionally examined the role of radiomic features characterizing lesion dissemination and reported that combining them with baseline MTV further improves risk stratification in DLBCL patients [76]. However, MTV calculation was carried out rather inconsistently in different working groups, which used both adaptive and fixed thresholds ( Figure 2, Table 2).…”
Section: Recent Advances and Future Directionsmentioning
Since the mid-1990s, 18F-fluorodeoxglucose (FDG)-positron emission tomography (PET) in combination with computed tomography has come to play a prominent role in the management of malignant lymphomas. One of the first PET applications in oncology was the detection of lymphoma manifestations at staging, where it has shown high sensitivity. Nowadays, this imaging modality is also used during treatment to evaluate the individual chemosensitivity and adapt further therapy accordingly. If the end-of-treatment PET is negative, irradiation in advanced-stage Hodgkin lymphoma patients can be safely omitted after highly effective chemotherapy. Thus far, lymphoma response assessment has mainly been performed using visual criteria, such as the Deauville five-point scale, which became the international standard in 2014. However, novel measures such as metabolic tumor volume or total lesion glycolysis have recently been recognized by several working groups and may further increase the diagnostic and prognostic value of FDG-PET in the future.
“…These parameters consider the disease as a whole and can characterize all tumour locations. This type of parameters is well suited to some cancers, notably lymphomas and probably metastatic solid cancers, as shown by the predictive value of known parameters like TMTV [5], TVSR [12] or Dmax [20].…”
Section: Discussionmentioning
confidence: 99%
“…The twelve following parameters were determined on the baseline PET/CT by an in-house software called “Oncometer3D”, with a graphical representation of the parameters visible in Fig. 3 : (1) SUVmax, the highest maximal standardized uptake value (SUV) measured in all tumours, (2) SUVmean, the mean value of SUV measured in all tumours, (3) total metabolic tumour volume (TMTV) obtained by summing the metabolic volumes of all the nodal and extra-nodal lesions, (4) total lesion glycolysis (TLG) calculated as the product of the MTV and the SUVmean (TLG = TMTV × SUVmean), (5) total metabolic tumour surface (TMTS) obtained by summing the metabolic surfaces of all tumours [ 12 ], (6) tumour volume surface ratio (TVSR) corresponding to the ratio of the TMTV and the TMTS [ 12 ], (7) volume of the bounding box including the tumours (TumBB) corresponding to the volume of tumour dispersion, (8) the maximal tumour distance (Dmax) corresponding to the distance between the two lesions that were the furthest apart [ 20 ], (9) the number of regions of interest (nROI) corresponding to the number of unique tumour on the whole examination, (10) iterative erosion (itErosion) corresponding to the number of erosions [ 30 ] required to remove tumours from the images, (11) the median distance between the centroid of the tumours and the periphery (medPCD), (12) the median edge distance (medEdgeD) corresponding to the median distance between the opposite edges of the tumours. Figure 3 Representation of the twelve different PET parameters measured by the software Oncometer3D and analysing burden, activity, dispersion, fragmentation and massiveness of the lymphoma.…”
Background
18F-FDG PET/CT is a standard for many B cell malignancies, while blood DNA measurements are emerging tools. Our objective was to evaluate the correlations between baseline PET parameters and circulating DNA in diffuse large B cell lymphoma (DLBCL) and classical Hodgkin lymphoma (cHL).
Methods
Twenty-seven DLBCL and forty-eight cHL were prospectively included. Twelve PET parameters were analysed. Spearman’s correlations were used to compare PET parameters each other and to circulating cell-free DNA ([cfDNA]) and circulating tumour DNA ([ctDNA]). p values were controlled by Benjamini–Hochberg correction.
Results
Among the PET parameters, three different clusters for tumour burden, fragmentation/massiveness and dispersion parameters were observed. Some PET parameters were significantly correlated with blood DNA parameters, including the total metabolic tumour surface (TMTS) describing the tumour–host interface (e.g. ρ = 0.81 p < 0.001 for [ctDNA] of DLBLC), the tumour median distance between the periphery and the centroid (medPCD) describing the tumour’s massiveness (e.g. ρ = 0.81 p < 0.001 for [ctDNA] of DLBLC) and the volume of the bounding box including tumours (TumBB) describing the disease’s dispersion (e.g. ρ = 0.83 p < 0.001 for [ctDNA] of DLBLC).
Conclusions
Some PET parameters describing tumour burden, fragmentation/massiveness and dispersion are significantly correlated with circulating DNA parameters of DLBCL and cHL patients. These results could help to understand the pathophysiology of B cell malignancies.
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