Takeda Kazuya, Takanami Kentaro, Shirata Yuko, Yamamoto Takaya, Takahashi Noriyoshi, Ito Kengo, Takase Kei, Jingu Keiichi
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
J Radiat Res. 2017 Nov 1;58(6):862-869. doi: 10.1093/jrr/rrx050.
We evaluated the reproducibility and predictive value of texture parameters and existing parameters of 18F-FDG PET/CT images in Stage I non-small-cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT). Twenty-six patients with Stage I NSCLC (T1-2N0M0) were retrospectively analyzed. All of the patients underwent an 18F-FDG PET/CT scan before treatment and were treated with SBRT. Each tumor was delineated using PET Edge (MIM Software Inc., Cleveland, OH), and texture parameters were calculated using open-source code CGITA. From 18F-FDG PET/CT images, three conventional parameters, including maximum standardized uptake value (SUV), metabolic tumor volume (MTV) and total lesion glycolysis (TLG), and four texture parameters, including entropy and dissimilarity (derived from a co-occurrence matrix) and high-intensity large-area emphasis (HILAE) and zone percentage (derived from a size-zone matrix) were analyzed. Reproducibility was evaluated using two independent delineations conducted by two observers. The ability to predict local control (LC), progression-free survival (PFS) and overall survival (OS) was tested for each parameter. All of the seven parameters except zone percentage showed good reproducibility, with intraclass correlation coefficient values >0.8. In univariate analysis, only HILAE was a significant predictor for LC. Histology, dose fractionation, and maximum SUV were associated with PFS, and histology and dose fractionation were associated with OS. We showed that texture parameters derived from 18F-FDG PET/CT were reproducible and potentially beneficial for predicting LC in Stage I lung cancer patients treated with SBRT.
我们评估了18F-FDG PET/CT图像的纹理参数和现有参数在接受立体定向体部放疗（SBRT）的I期非小细胞肺癌（NSCLC）患者中的可重复性和预测价值。对26例I期NSCLC（T1-2N0M0）患者进行了回顾性分析。所有患者在治疗前均接受了18F-FDG PET/CT扫描，并接受了SBRT治疗。使用PET Edge（MIM Software Inc.，克利夫兰，俄亥俄州）勾勒出每个肿瘤，并使用开源代码CGITA计算纹理参数。从18F-FDG PET/CT图像中，分析了三个传统参数，包括最大标准化摄取值（SUV）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG），以及四个纹理参数，包括熵和相异度（来自共生矩阵）以及高强度大面积强调（HILAE）和区域百分比（来自大小区域矩阵）。使用两名观察者进行的两次独立勾勒来评估可重复性。对每个参数预测局部控制（LC）、无进展生存期（PFS）和总生存期（OS）的能力进行了测试。除区域百分比外，所有七个参数均显示出良好的可重复性，组内相关系数值>0.8。在单变量分析中，只有HILAE是LC的显著预测因子。组织学、剂量分割和最大SUV与PFS相关，组织学和剂量分割与OS相关。我们表明，从18F-FDG PET/CT得出的纹理参数具有可重复性，并且可能有助于预测接受SBRT治疗的I期肺癌患者的LC。
