Liberini Virginia, Rampado Osvaldo, Gallio Elena, De Santi Bruno, Ceci Francesco, Dionisi Beatrice, Thuillier Philippe, Ciuffreda Libero, Piovesan Alessandro, Fioroni Federica, Versari Annibale, Molinari Filippo, Deandreis Désirée
Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
Medical Physics Unit, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy.
Front Med (Lausanne). 2021 Jan 26;7:601853. doi: 10.3389/fmed.2020.601853. eCollection 2020.
This work aims to evaluate whether the radiomic features extracted by 68Ga-DOTATOC-PET/CT of two patients are associated with the response to peptide receptor radionuclide therapy (PRRT) in patients affected by neuroendocrine tumor (NET). This is a pilot report in two NET patients who experienced a discordant response to PRRT (responder vs. non-responder) according to RECIST1.1. The patients presented with liver metastasis from the rectum and pancreas G3-NET, respectively. Whole-body total-lesion somatostatin receptor-expression (TLSREwb-50) and somatostatin receptor-expressing tumor volume (SRETV wb-50) were obtained in pre- and post-PRRT PET/CT. Radiomic analysis was performed, extracting 38 radiomic features (RFs) from the patients' lesions. The Mann-Whitney test was used to compare RFs in the responder patient vs. the non-responder patient. Pearson correlation and principal component analysis (PCA) were used to evaluate the correlation and independence of the different RFs. TLSREwb-50 and SRETVwb-50 modifications correlate with RECIST1.1 response. A total of 28 RFs extracted on pre-therapy PET/CT showed significant differences between the two patients in the Mann-Whitney test ( < 0.05). A total of seven second-order features, with poor correlation with SUVmax and PET volume, were identified by the Pearson correlation matrix. Finally, the first two PCA principal components explain 83.8% of total variance. TLSREwb-50 and SRETVwb-50 are parameters that might be used to predict and to assess the PET response to PRRT. RFs might have a role in defining inter-patient heterogeneity and in the prediction of therapy response. It is important to implement future studies with larger and more homogeneous patient populations to confirm the efficacy of these biomarkers.
这项工作旨在评估两名患者的68Ga-DOTATOC-PET/CT提取的放射组学特征是否与神经内分泌肿瘤（NET）患者对肽受体放射性核素治疗（PRRT）的反应相关。这是一份针对两名NET患者的初步报告，根据RECIST1.1标准，这两名患者对PRRT的反应不一致（反应者与无反应者）。这两名患者分别表现为直肠和胰腺G3-NET的肝转移。在PRRT前和PRRT后的PET/CT中获取全身总病灶生长抑素受体表达（TLSREwb-50）和生长抑素受体表达肿瘤体积（SRETV wb-50）。进行了放射组学分析，从患者病变中提取了38个放射组学特征（RFs）。采用曼-惠特尼检验比较反应者患者与无反应者患者的RFs。使用Pearson相关性分析和主成分分析（PCA）来评估不同RFs的相关性和独立性。TLSREwb-50和SRETVwb-50的变化与RECIST1.1反应相关。在治疗前PET/CT上提取的总共28个RFs在曼-惠特尼检验中显示出两名患者之间存在显著差异（<0.05）。通过Pearson相关矩阵确定了总共七个与SUVmax和PET体积相关性较差的二阶特征。最后，前两个PCA主成分解释了总方差的83.8%。TLSREwb-50和SRETVwb-50可能是用于预测和评估PET对PRRT反应的参数。RFs可能在定义患者间异质性和预测治疗反应方面发挥作用。开展未来研究，纳入更大且更同质的患者群体以证实这些生物标志物的有效性很重要。
