Baseline 18F-FDG PET textural features as predictors of response to chemotherapy in diffuse large B-cell lymphoma

Abstract

Purpose We sought to investigate the performance of radiomics analysis on baseline 18F-FDG PET/CT for predicting response to first-line chemotherapy in diffuse large B-cell lymphoma (DLBCL). Material and methods Forty-five patients who received first-line rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy for DLBCL were included in the study. Radiomics features and standard uptake value (SUV)-based measurements were extracted from baseline PET images for a total of 147 lesions. The selection of the most relevant features was made using the recursive feature elimination algorithm. A machine-learning model was trained using the logistic regression classifier with cross-validation to predict treatment response. The independent predictors of incomplete response were evaluated with multivariable regression analysis. Results A total of 14 textural features were selected by the recursive elimination algorithm, achieving a feature-to-lesion ratio of 1:10. The accuracy and area under the receiver operating characteristic curve of the model for predicting incomplete response were 0.87 and 0.81, respectively. Multivariable analysis revealed that SUVmax and gray level co-occurrence matrix dissimilarity were independent predictors of lesions with incomplete response to first-line R-CHOP chemotherapy. Conclusion Increased textural heterogeneity in baseline PET images was found to be associated with incomplete response in DLBCL.

Radiomics analysis of pre-treatment F-18 FDG PET/CT for predicting response to transarterial radioembolization in liver tumors

“…An indicator of tumor aggressiveness other than SUVmax is the increased genotypic and phenotypic heterogeneity within the tumor, which can be noninvasively quantified with radiomics analysis. We have previously shown that there are strong correlations between the textural features extracted from PET images and the SUVmax values (30). Our findings should be interpreted in the context of several limitations.…”

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

“…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.…”

“…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.…”

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

“…Another study has taken a somewhat different approach, evaluating 45 patients receiving R-CHOP (Rituximab+ Cyclophosphamide + Doxorubicin + Vincristine + Prednisone) chemotherapy for DLBCL, evaluating the ability to predict therapy response [40]. Here, the authors concluded that that SUV max and gray level co-occurrence matrix dissimilarity were independent predictors of lesions with incomplete response.…”

“…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]…”