Prognostic value of 18 F-FDG PET/CT with texture analysis in patients with rectal cancer treated by surgery

The aim of this study was to evaluate the ability of texture analysis using pretreatment F-FDG PET/CT to predict prognosis in patients with surgically treated rectal cancer. We analyzed 94 patients with pathologically proven rectal cancer who underwent pretreatment F-FDG PET/CT and were subsequently...

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Bibliographic Details
Published in:Annals of nuclear medicine 2021-07, Vol.35 (7), p.843
Main Authors: Hotta, Masatoshi, Minamimoto, Ryogo, Gohda, Yoshimasa, Miwa, Kenta, Otani, Kensuke, Kiyomatsu, Tomomichi, Yano, Hideaki
Format: Article
Language:English
Subjects:
Aged
Female
Fluorodeoxyglucose F18
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Prognosis
Rectal Neoplasms - diagnostic imaging
Rectal Neoplasms - pathology
Rectal Neoplasms - surgery
Rectal Neoplasms - therapy
Retrospective Studies
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Summary:The aim of this study was to evaluate the ability of texture analysis using pretreatment F-FDG PET/CT to predict prognosis in patients with surgically treated rectal cancer. We analyzed 94 patients with pathologically proven rectal cancer who underwent pretreatment F-FDG PET/CT and were subsequently treated with surgery. The volume of interest of the primary tumor was defined using a threshold of 40% of the maximum standardized uptake value (SUVmax), and conventional (SUVmax, metabolic tumor volume [MTV], total lesion glycolysis [TLG]) and textural PET features were extracted. Harmonization of PET features was performed with the ComBat method. The study endpoints were overall survival (OS) and progression-free survival (PFS), and the prognostic value of PET features was evaluated by Cox regression analysis. In the follow-up period (median 41.7 [interquartile range, 30.5-60.4] months), 21 (22.3%) and 30 (31.9%) patients had cancer-related death or disease progression, respectively. Univariate analysis revealed a significant association of (1) MTV, TLG, and gray-level co-occurrence matrix (GLCM) entropy with OS; and (2) SUVmax, MTV, TLG, and GLCM entropy with PFS. In multivariate analysis including clinical characteristics, GLCM entropy (≥ 2.13) was the only relevant prognostic PET feature for poor OS (hazard ratio [HR]: 4.16, p = 0.035) and PFS (HR: 2.70, p = 0.046). GLCM entropy, which indicates metabolic intratumoral heterogeneity, was an independent prognostic factor in patients with surgically treated rectal cancer. Compared with conventional PET features, GLCM entropy has better predictive value and shows potential to facilitate precision medicine.
ISSN:1864-6433