Textural Features of Pretreatment 18F-FDG PET/CT Images: Prognostic Significance in Patients with Advanced T-Stage Oropharyngeal Squamous Cell Carcinoma
Textural Features of Pretreatment 18F-FDG PET/CT Images: Prognostic Significance in Patients with Advanced T-Stage Oropharyngeal Squamous Cell Carcinoma
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DOI：
10.2967/jnumed.112.119289
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发表时间：
2013-10-01
影响因子：
9.3
通讯作者：
Yen, Tzu-Chen
中科院分区：
文献类型：
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作者：
Cheng, Nai-Ming;Fang, Yu-Hua Dean;Yen, Tzu-Chen
以往的研究表明，总病变糖酵解（TLG）可以作为口咽鳞状细胞癌（OPSCC）的预后指标。我们试图研究治疗前F-18-FDG PET/CT图像的纹理特征是否可以提供晚期T期OPSCC患者的TLG和临床分期的任何额外的预后信息。研究方法：我们回顾性分析了70例晚期T期OPSCC患者的治疗前F-18-FDG PET/CT图像，这些患者完成了同步放化疗、生物放疗或根治性放疗。所有患者都有人乳头瘤病毒（HPV）感染的数据，并随访至少24个月或直至死亡。标准化摄取值（SUV）2.5作为肿瘤边界的截止值。从直方图分析（SUV方差和SUV熵）、归一化灰度共生矩阵（均匀性、熵、相异性、对比度、同质性、逆差矩和相关性）和邻域灰度差异矩阵（粗糙度、对比度、繁忙度、复杂度和强度）中提取预处理后F-18-FDG PET/CT图像的纹理特征。接收器操作特性曲线被用来确定最佳的纹理特征和TLG的截止值。结果：13例HPV阳性。多变量考克斯回归分析显示，年龄、肿瘤TLG和均匀性与无进展生存期（PFS）和疾病特异性生存期（DSS）独立相关。TLG、均匀性和HPV阳性与总生存期（OS）显著相关。基于TLG和均匀性的预后评分系统。TLG > 121.9 g且均匀性> 121.9 g或均匀性> 121.9 g的患者
Previous studies have shown that total lesion glycolysis (TLG) may serve as a prognostic indicator in oropharyngeal squamous cell carcinoma (OPSCC). We sought to investigate whether the textural features of pretreatment F-18-FDG PET/CT images can provide any additional prognostic information over TLG and clinical staging in patients with advanced T-stage OPSCC. Methods: We retrospectively analyzed the pretreatment F-18-FDG PET/CT images of 70 patients with advanced T-stage OPSCC who had completed concurrent chemoradiotherapy, bioradiotherapy, or radiotherapy with curative intent. All of the patients had data on human papillomavirus (HPV) infection and were followed up for at least 24 mo or until death. A standardized uptake value (SUV) of 2.5 was taken as a cutoff for tumor boundary. The textural features of pretreatment F-18-FDG PET/CT images were extracted from histogram analysis (SUV variance and SUV entropy), normalized gray-level cooccurrence matrix (uniformity, entropy, dissimilarity, contrast, homogeneity, inverse different moment, and correlation), and neighborhood gray-tone difference matrix (coarseness, contrast, busyness, complexity, and strength). Receiver-operating-characteristic curves were used to identify the optimal cutoff values for the textural features and TLG. Results: Thirteen patients were HPV-positive. Multivariate Cox regression analysis showed that age, tumor TLG, and uniformity were independently associated with progression-free survival (PFS) and disease-specific survival (DSS). TLG, uniformity, and HPV positivity were significantly associated with overall survival (OS). A prognostic scoring system based on TLG and uniformity was derived. Patients who presented with TLG > 121.9 g and uniformity 121.9 g or uniformity