复发性胶质母细胞瘤的 FET-PET 放射组学：再放疗后结局的预后价值？
FET-PET radiomics in recurrent glioblastoma: prognostic value for outcome after re-irradiation?
机构信息
Division of Medical Physics, Department of Radiation Oncology, Medical Center, University of Freiburg, Robert-Koch Str. 3, 79106, Freiburg, Germany.
German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Partner Site Freiburg, Heidelberg, Germany.
出版信息
Radiat Oncol. 2021 Mar 3;16(1):46. doi: 10.1186/s13014-020-01744-8.
PURPOSE
The value of O-(2-[18F]fluoroethyl)-L-tyrosine (FET)-positron emission tomography (PET)-radiomics in the outcome assessment of patients with recurrent glioblastoma (rGBM) has not been evaluated until now. The aim of this study was to evaluate whether a prognostic model based on FET-PET radiomics features (RF) is feasible and can identify rGBM patients that would most benefit from re-irradiation.
METHODS
We prospectively recruited rGBM patients who underwent FET-PET before re-irradiation (GLIAA-Pilot trial, DRKS00000633). Tumor volume was delineated using a semi-automatic method with a threshold of 1.8 times the standardized-uptake-value of the background. 135 FET-RF (histogram parameters, shape and texture features) were extracted. The analysis involved the characterization of tumor and non-tumor tissue with FET-RF and the evaluation of the prognostic value of FET-RF for time-to-progression (TTP), overall survival (OS) and recurrence location (RL).
RESULTS
Thirty-two rGBM patients constituted our cohort. FET-RF discriminated significantly between tumor and non-tumor. The texture feature Small-Zone-Low-Gray-Level-Emphasis (SZLGE) showed the best performance for the prediction of TTP (p = 0.001, satisfying Bonferroni-multiple-test significance level). Additionally, two radiomics signatures could predict TTP (TTP-radiomics-signature, p = 0.001) and OS (OS-radiomics-signature, p = 0.038). SZLGE and the TTP-radiomics-signature additionally predicted RL. Specifically, high values for TTP-radiomics-signature and for SZLGE indicated not only earlier progression, but also a RL within the initial FET-PET active volume.
CONCLUSION
Our findings suggest that FET-PET radiomics could contribute to the prognostic assessment and selection of rGBM-patients benefiting from re-irradiation. Trial registration DRKS00000633. Registered on 8th of December in 2010. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00000633 .
目的
O-(2-[18F] 氟乙基)-L-酪氨酸（FET）正电子发射断层扫描（PET）-放射组学在复发性胶质母细胞瘤（rGBM）患者预后评估中的价值尚未得到评估。本研究旨在评估基于 FET-PET 放射组学特征（RF）的预后模型是否可行，并能否识别最受益于再放疗的 rGBM 患者。
方法
我们前瞻性招募了在再放疗前接受 FET-PET 检查的 rGBM 患者（GLIAA-Pilot 试验，DRKS00000633）。使用半自动方法，以背景标准化摄取值的 1.8 倍为阈值勾勒肿瘤体积。提取 135 个 FET-RF（直方图参数、形状和纹理特征）。该分析涉及使用 FET-RF 对肿瘤和非肿瘤组织进行特征描述，并评估 FET-RF 对进展时间（TTP）、总生存期（OS）和复发部位（RL）的预后价值。
结果
我们的队列由 32 名 rGBM 患者组成。FET-RF 可显著区分肿瘤和非肿瘤组织。纹理特征 Small-Zone-Low-Gray-Level-Emphasis（SZLGE）在预测 TTP 方面表现最佳（p=0.001，满足 Bonferroni 多重检验显著性水平）。此外，两个放射组学特征可以预测 TTP（TTP-放射组学特征，p=0.001）和 OS（OS-放射组学特征，p=0.038）。SZLGE 和 TTP-放射组学特征还可以预测 RL。具体来说，TTP-放射组学特征和 SZLGE 值较高不仅预示着更早的进展，而且预示着 RL 位于初始 FET-PET 活跃体积内。
结论
我们的研究结果表明，FET-PET 放射组学可能有助于评估 rGBM 患者的预后，并选择受益于再放疗的患者。试验注册 DRKS00000633。于 2010 年 12 月 8 日注册。https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00000633。
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