Integrating quantitative morphological and intratumoural textural characteristics in FDG-PET for the prediction of prognosis in pharynx squamous cell carcinoma patients

Abstract

Aim: We assessed potential prognostic factors in pharynx squamous cell carcinoma (SCC) patients by quantitative morphological and intratumoural characteristics obtained by 18 F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT). Materials and Methods: We retrospectively analyzed the cases of 54 patients with pharynx SCC who underwent chemoradiation therapy. Using their FDG-PET data, we calculated the quantitative morphological and intratumoural characteristics of 14 parameters. The progression-free survival (PFS) and overall survival (OS) information was obtained from patient medical records. We performed univariate and multivariate analyses to assess the 14 quantitative parameters as well as the T-stage, N-stage and tumour location data for their relation to PFS and OS. When an independent predictor was suggested in the multivariate analysis, the parameter was further assessed by the Kaplan-Meier method. Results: In the assessment of PFS, the univariate and multivariate analyses indicated the following as independent predictors: the texture parameter of homogeneity, and the morphological parameter of sphericity. In the Kaplan-Meier analysis, the PFS rate was significantly improved in the patients who had both a higher value of homogeneity (p=0.01) and a higher value of sphericity (p=0.002). With the combined use of homogeneity and sphericity, we could divide the patients with different PFS rates more clearly. Conclusion: The quantitative parameters of homogeneity and sphericity obtained by FDG-PET can be useful for the prediction of the PFS of pharynx SCC patients, especially when used in combination.

A Systematic Review of PET Textural Analysis and Radiomics in Cancer

“…We collected information from 60 articles that satisfy our selection criteria and evaluated head and neck cancer [ 28 , 82 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , ...…”

Evaluation of CT-based radiomics signature and nomogram as prognostic markers in patients with laryngeal squamous cell carcinoma

“…In histogram analysis, a pixel distribution with higher kurtosis, energy and entropy, and a positive or negative skewness indicated the enhancement of tumors heterogeneity [31,32]. The high homogeneity of PET-CT images also was revealed as predictors of progression-free survival in pharynx cancer [33]. In terms of third order metrics, significant differences of GLRLM features were found between regional control group and local recurrence group in HNSCC patients treated with chemoradiotherapy [16].…”

Texture indices of 4′-[methyl-11C]-thiothymidine uptake predict p16 status in patients with newly diagnosed oropharyngeal squamous cell carcinoma: Comparison with 18F-FDG uptake

“…In the present study, the expression of p16 associated with higher homogeneity, lower SRE, higher LRE, and lower HGZE values on 11 C-4DST PET, although this association was not present on 11 C-4DST SUVmax. The prognostic information of 18 F-FDG PET textural indices in patients with pharyngeal cancer has been studied (Chan et al, 2017;Chen et al, 2017;Cheng et al, 2015;Wang et al, 2016;Fujima et al, 2018;Cheng et al, 2013). Chan et al proved that heterogeneity on 18 F-FDG PET was prognostically superior to traditional SUV parameters in such patients (Chan et al, 2017).…”

“…found 18 F-FDG PET heterogeneity to be prognostically superior to traditional SUV parameters in patients with pharyngeal cancer (Chan et al, 2017). Several investigators have focused on the textural features of 18 F-FDG PET in patients with HNSCC, but the number of such studies remains very small (Chan et al, 2017;Chen et al, 2017;Cheng et al, 2015;Wang et al, 2016;Fujima et al, 2018).…”