Texture Analysis Improves the Value of Pretreatment ¹⁸F-FDG PET/CT in Predicting Interim Response of Primary Gastrointestinal Diffuse Large B-Cell Lymphoma

Abstract

Objectives. To explore the application of pretreatment 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) texture analysis (TA) in predicting the interim response of primary gastrointestinal diffuse large B-cell lymphoma (PGIL-DLBCL). Methods. Pretreatment 18F-FDG PET/CT images of 30 PGIL-DLBCL patients were studied retrospectively. The interim response was evaluated after 3-4 cycles of chemotherapy. The complete response (CR) rates in patients with different clinicopathological characteristics were compared by Fisher’s exact test. The differences in the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and texture features between the CR and non-CR groups were compared by the Mann–Whitney U test. Feature selection was performed according to the results of the Mann–Whitney U test and feature categories. The predictive efficacies of the SUVmax, MTV, and the selected texture features were assessed by receiver operating characteristic (ROC) analysis. A prediction probability was generated by binary logistic regression analysis. Results. The SUVmax, MTV, some first-order texture features, volume, and entropy were significantly higher in the non-CR group. The energy was significantly lower in the non-CR group. The SUVmax, volume, and entropy were excellent predictors of the interim response, and the areas under the curves (AUCs) were 0.850, 0.805, and 0.800, respectively. The CR rate was significantly lower in patients with intestinal involvement. The prediction probability generated from the combination of the SUVmax, entropy, volume, and intestinal involvement had a higher AUC (0.915) than all single parameters. Conclusions. TA has potential in improving the value of pretreatment PET/CT in predicting the interim response of PGIL-DLBCL. However, prospective studies with large sample sizes and validation analyses are needed to confirm the current results.

A Systematic Review of PET Textural Analysis and Radiomics in Cancer

“…We collected 18 papers about radiomics in blood cancers [ 82 , 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 , 234 , 235 , 236 , 237 , 238 , 239 , 240 ], most of them focusing on non-Hodgkin lymphoma (11/18) and Hodgkin lymphoma (4/18). The average number of patients included was 77 (median = 51, range, 24–251) and the average number of evaluated textures was 28 (median = 22, range, 3–78), extracted mainly from the GLCM (100%), the GLZSM (56%) and the GLRLM (50%).…”

Clinicopathological spectrum of Diffuse Large B Cell lymphoma: a study targeting population yet unexplored in Pakistan

“…Incidence of extra nodal lymphomas has increased significantly especially in Pakistan [ 7 , 12 ]. Different extra nodal sites are involved out of which, GIT is the most common primary extra nodal site and DLBCL is the most common type of lymphoma in primary gastrointestinal lymphoma [ 13 ]. In our study we enrolled 138 patients with DLBCL and observed the frequency of nodal and primary extra nodal DLBCL in our setup, comprising of patients from all over Pakistan with a large proportion of patients from Northern and tribal areas.…”

Value of CT-Textural Features and Volume-Based PET Parameters in Comparison to Serologic Markers for Response Prediction in Patients with Diffuse Large B-Cell Lymphoma Undergoing CD19-CAR-T Cell Therapy

“…The latter has been further refined by calculating the entire metabolic tumor volume (MTV) and the total lesion glycolysis (TLG). Both PET and CT image data can be additionally analyzed by using texture analysis with potential for tumor characterization either in the primary setting (baseline) for prognosis evaluation, or during therapy as an adjunct to morphologic and metabolic changes for more accurate response assessment [ 9 , 10 ]. Finally, some laboratory biomarkers like lactate dehydrogenase (LDH) in serum have been used for a long time as prognostic factors in lymphoma patients.…”