1. Radiomic features of glucose metabolism enable prediction of outcome in mantle cell lymphoma
- Author
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Christopher C. Riedl, Marius E. Mayerhoefer, Anita Kumar, Heiko Schöder, Peter Gibbs, Michael Weber, Juliana Schilksy, and Ilan Tal
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Lymphoma ,FDG ,PET/CT ,Lymphoma, Mantle-Cell ,Logistic regression ,Disease-Free Survival ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Positron Emission Tomography Computed Tomography ,medicine ,Image Processing, Computer-Assisted ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Aged ,Retrospective Studies ,PET-CT ,business.industry ,Metabolic risk ,Retrospective cohort study ,General Medicine ,medicine.disease ,Prognosis ,Glucose ,030220 oncology & carcinogenesis ,Mantle cell lymphoma ,Original Article ,Female ,business ,Multilayer perceptron neural network - Abstract
Purpose To determine whether [18F]FDG PET/CT-derived radiomic features alone or in combination with clinical, laboratory and biological parameters are predictive of 2-year progression-free survival (PFS) in patients with mantle cell lymphoma (MCL), and whether they enable outcome prognostication. Methods Included in this retrospective study were 107 treatment-naive MCL patients scheduled to receive CD20 antibody-based immuno(chemo)therapy. Standardized uptake values (SUV), total lesion glycolysis, and 16 co-occurrence matrix radiomic features were extracted from metabolic tumour volumes on pretherapy [18F]FDG PET/CT scans. A multilayer perceptron neural network in combination with logistic regression analyses for feature selection was used for prediction of 2-year PFS. International prognostic indices for MCL (MIPI and MIPI-b) were calculated and combined with the radiomic data. Kaplan–Meier estimates with log-rank tests were used for PFS prognostication. Results SUVmean (OR 1.272, P = 0.013) and Entropy (heterogeneity of glucose metabolism; OR 1.131, P = 0.027) were significantly predictive of 2-year PFS: median areas under the curve were 0.72 based on the two radiomic features alone, and 0.82 with the addition of clinical/laboratory/biological data. Higher SUVmean in combination with higher Entropy (SUVmean >3.55 and entropy >3.5), reflecting high “metabolic risk”, was associated with a poorer prognosis (median PFS 20.3 vs. 39.4 months, HR 2.285, P = 0.005). The best PFS prognostication was achieved using the MIPI-bm (MIPI-b and metabolic risk combined): median PFS 43.2, 38.2 and 20.3 months in the low-risk, intermediate-risk and high-risk groups respectively (P = 0.005). Conclusion In MCL, the [18F]FDG PET/CT-derived radiomic features SUVmean and Entropy may improve prediction of 2-year PFS and PFS prognostication. The best results may be achieved using a combination of metabolic, clinical, laboratory and biological parameters.
- Published
- 2019