Search

To explore the role of radiomics in integrating primary tumor and peritumoral areas based on PET-CT scans for predicting E-cadherin (E-cad) expression in early-stage cervical cancer (ESCC) and its correlation with pelvic lymph node metastasis (PLNM).Ninety-seven ESCC patients who had undergone PET-CT scans were retrospectively analyzed. The ROI of primary tumors, peritumoral areas, and plus tumors were semi-automatically segmented on PET-CT images. A total of 1188 radiomics features were extracted, selected, and eventually integrated into radiomics score (rad-score). The rad-score difference between patients with E-cad expression of high and low was analyzed using Mann-Whitney tests. Characteristic correlation was tested using a Spearman analysis. Four models were established using logistic regression algorithms and evaluated using ROC and calibration curves. A DeLong test was used to perform pairwise comparisons of AUCs.The rad-score of patients with low E-cad expression was higher than that of patients with high E-cad expression in both training and testing cohorts (p0.001 and p = 0.027, respectively). A significant correlation was observed between the rad-score and E-cad (p0.001). PLNM correlated slightly with rad-score and E-cad values (p = 0.01 and p0.001, respectively). The ROC curve and calibration curve of the rad-score model performed best in both training and testing cohorts (AUC = 0.915, 0.844, p0.001, respectively).The radiomics of integrating primary tumor and peritumoral areas based on PET-CT showed correlations with PLNM. It was also able to predict E-cad expression in ESCC patients, allowing for evaluation of those patients' prognosis and more individualized medical treatment.• By integrating the primary tumor and peritumoral area based on PET-CT, radiomics was feasible. • The rad-score was associated with E-cad expression and PLNM in patients with ESCC. • Radiomics that integrated the primary tumor and peritumoral areas based on PET-CT could predict E-cad expression in patients with ESCC.

ObjectiveThis study aimed to compare the tumor volume between magnetic resonance imaging–defined gross tumor volume (MR-GTV) and positron emission tomography–defined GTV (PET-GTV) in cervical cancer with hybrid PET/MR.Materials and MethodsTwenty-seven patients with cervical cancer underwent PET/MR pelvic examination before radiotherapy. The MR-GTV was manually outlined on T2-weighted MR images. The PET-GTV was autocontoured on PET images using a 40% maximum standardized uptake value threshold. Results were analyzed by Pearson analysis, Bland-Altman plot, and 1-way analysis of variance.ResultsMagnetic resonance imaging–GTV significantly correlated with PET-GTV (r2 = 0.797, P < 0.001). The Bland-Altman plot showed a bad agreement between MR-GTV and PET-GTV. The PET-GTV underestimated the MR-GTV in 23 of 27 tumors. Patients were divided into the following 3 groups according to MR-GTV: less than 14 mL (n = 6), 14 to 62 mL (n = 12), and 62 mL or more (n = 9). The mean (SD) MR-GTV, PET-GTV, ratio, and overlap between MR-GTV and PET-GTV for the less than 14 mL cohort were 9.6 (2.6) mL, 16.7 (10.1) mL, 0.77 (0.40), and 0.47 (0.20), respectively. The PET-GTV overestimated MR-GTV in 4 of the 6 lesions by a mean (SD) of 11.1 (9.4) mL. Among the 14 to 62 mL cohort, the mean (SD) MR-GTV, PET-GTV, ratio, and overlap were 38.6 (14.5) mL, 24.9 (8.6 mL), 1.54 (0.25), and 0.87 (0.08), respectively. The PET-GTV underestimated MR-GTV for 12 tumors by a mean (SD) of 13.7 (8.4) mL. In the 62 mL or more cohort, the mean (SD) MR-GTV, PET-GTV, ratio, and overlap were 85.9 (25.8) mL, 54.3 (14.1) mL, 1.61 (0.35), and 0.87 (0.09), respectively. The PET-GTV underestimated MR-GTV 9 tumors by a mean (SD) of 31.6 (19.5) mL. The ratio and overlap differences were statistically significant among groups (F = 14.619, P < 0.001; F = 25.134, P < 0.001).ConclusionsTumor volume discrepancies were observed between MR-GTV and PET-GTV for cervical cancer. With an increasing tumor volume, there was an increase in the difference between MR-GTV and PET-GTV. In addition, larger tumors had a higher degree of overlap compared with small tumors.

Seizures may be the first or sometimes the only manifestation of patients with glioma in clinics. The aim of operation is to eliminate epilepsy far beyond mere resection of tumor mass. The underlying mechanisms of glioma-associated epileptogenesis are poorly understood. Recently the theory of amino-acid like neurotransmitters in chemical synapse is gradually accepted. However, the molecular mechanisms remain to be further investigated on how glutamate release is regulated and how synaptic homeostasis in peripheral neurons is kept or disturbed. So detailed studies are needed to clarify specific molecular target and provide proper evidence for optimal antiepileptic drugs in glioma-associated epileptogenesis.