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.

中文翻译：

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葡萄糖代谢的放射学特征使得能够预测套细胞淋巴瘤的预后。

目的确定[18F] FDG PET / CT衍生的放射学特征是否单独或结合临床，实验室和生物学参数是否可预测套细胞淋巴瘤（MCL）患者的2年无进展生存期（PFS），以及它们是否能够进行预后。方法该回顾性研究包括107例未接受过治疗的MCL患者，这些患者计划接受基于CD20抗体的免疫（化学）治疗。在治疗前[18F] FDG PET / CT扫描中，从代谢肿瘤体积中提取了标准摄取值（SUV），总病变糖酵解和16个共现基质放射学特征。多层感知器神经网络结合逻辑回归分析进行特征选择，用于预测2年PFS。计算了MCL的国际预后指标（MIPI和MIPI-b），并将其与放射线数据结合。Kaplan-Meier估计与对数秩检验用于PFS预后。结果SUVmean（OR 1.272，P = 0.013）和熵（葡萄糖代谢异质性; OR 1.131，P = 0.027）可以显着预测2年的PFS：仅根据两个放射学特征，曲线下的中位数为0.72，并且0.82，并附加了临床/实验室/生物学数据。较高的SUVmean与较高的熵（SUVmean> 3.55和熵> 3.5）相结合，反映出较高的“代谢风险”，预后较差（中位PFS 20.3 vs. 39.4个月，HR 2.285，P = 0.005）。使用MIPI-bm（MIPI-b和代谢风险合计）可实现最佳的PFS预后：中位PFS为43.2、38.2和20。低风险，中风险和高风险组分别为3个月（P = 0.005）。结论在MCL中，[18F] FDG PET / CT衍生的放射学特征SUVmean和熵可改善2年PFS和PFS预后的预测。结合代谢，临床，实验室和生物学参数可以达到最佳结果。