AIM The aim was to validate promising radiomic features (RFs)1 on 18F-flourodeoxyglucose positron emission tomography/computed tomography-scans (18F-FDG PET/CT) of non-small cell lung cancer (NSCLC) patients undergoing definitive chemo-radiotherapy. METHODS 18F-FDG PET/CT scans performed for radiotherapy (RT) planning were retrieved. Auto-segmentation with visual adaption was used to define the primary tumour on PET images. Six pre-selected prognostic and reproducible PET texture -and shape-features were calculated using texture respectively shape analysis. The correlation between these RFs and metabolic active tumour volume (MTV)3, gross tumour volume (GTV)4 and maximum and mean of standardized uptake value (SUV)5 was tested with a Spearman's Rank test. The prognostic value of RFs was tested in a univariate cox regression analysis and a multivariate cox regression analysis with GTV, clinical stage and histology. P-value ≤ 0.05 were considered significant. RESULTS Image analysis was performed for 233 patients: 145 males and 88 females, mean age of 65.7 and clinical stage II-IV. Mean GTV was 129.87 cm3 (SD 130.30 cm3). Texture and shape-features correlated more strongly to MTV and GTV compared to SUV-measurements. Four RFs predicted PFS in the univariate analysis. No RFs predicted PFS in the multivariate analysis, whereas GTV and clinical stage predicted PFS (p = 0.001 and p = 0.008 respectively). CONCLUSION The pre-selected RFs were insignificant in predicting PFS in combination with GTV, clinical stage and histology. These results might be due to variations in technical parameters. However, it is relevant to question whether RFs are stable enough to provide clinically useful information.

中文翻译：

---

肿瘤的异质性：验证肺癌患者 18F-FDG PET/CT 扫描影像学特征作为预后工具的使用

目的 目的是在接受确定性放化疗的非小细胞肺癌 (NSCLC) 患者的 18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描 (18F-FDG PET/CT) 上验证有希望的放射组学特征 (RFs)1。方法 检索为​​放射治疗 (RT) 计划执行的 18F-FDG PET/CT 扫描。使用视觉自适应自动分割来定义 PET 图像上的原发肿瘤。使用纹理和形状分析计算了六个预先选择的预后和可再现的 PET 纹理和形状特征。这些 RF 与代谢活动性肿瘤体积 (MTV)3、总肿瘤体积 (GTV)4 以及标准化摄取值 (SUV)5 的最大值和平均值之间的相关性通过 Spearman 秩检验进行了测试。RFs 的预后价值在单变量 cox 回归分析和多变量 cox 回归分析中测试，包括 GTV、临床分期和组织学。P 值≤ 0.05 被认为是显着的。结果 对 233 名患者进行图像分析：男性 145 名，女性 88 名，平均年龄 65.7 岁，临床分期为 II-IV。平均 GTV 为 129.87 cm3 (SD 130.30 cm3)。与 SUV 测量相比，纹理和形状特征与 MTV 和 GTV 的相关性更强。在单变量分析中，四个 RF 预测了 PFS。在多变量分析中没有 RF 预测 PFS，而 GTV 和临床分期预测 PFS（分别为 p = 0.001 和 p = 0.008）。结论 预选的 RF 与 GTV、临床分期和组织学相结合，在预测 PFS 方面无显着意义。这些结果可能是由于技术参数的变化。然而，