Ripani Daria, Caldarella Carmelo, Za Tommaso, Rossi Elena, De Stefano Valerio, Giordano Alessandro
Dipartimento di Scienze Radiologiche ed Ematologiche, Istituto di Medicina Nucleare, Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, UOC di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Clin Lymphoma Myeloma Leuk. 2021 Aug;21(8):536-544. doi: 10.1016/j.clml.2021.03.014. Epub 2021 Apr 6.
This retrospective study is focused on the possible clinical implications of texture analysis-derived PET parameters in patients with smoldering multiple myeloma. Several texture features are significantly associated with progression to symptomatic multiple myeloma and with a shorter time to progression. The results of this study may lead to early identification of patients who could benefit from specific therapies.
The aim of the study was to determine whether positron emission tomography parameters derived from texture analysis of axial and peripheral skeleton predict progression to symptomatic multiple myeloma (MM) in patients undergoing 18F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) without evidence of focal sites of F-FDG uptake.
Patients with smoldering MM who underwent F-FDG PET/CT from May 2014 to June 2018 were retrospectively reviewed. Volumes of interest (VOIs) were placed on T5-T7 and L2-L4, iliac crests, and femoral diaphyses. Dedicated software (LIFEx) allowed us to obtain PET-derived first-, second-, and higher order texture features. Possible associations between PET parameters and progression to symptomatic MM were determined. Kaplan-Meier curves allowed to assess time to progression (TTP) based on the PET parameters.
Forty-five patients were included: 26 patients (58%) did not meet the criteria for symptomatic MM, but 19 patients (42%) progressed to symptomatic MM. Several texture features extracted from VOIs placed on iliac crests and femoral diaphyses were significantly associated with progression to symptomatic MM and with a shorter TTP (P < .05); conversely, the above-mentioned parameters extracted from VOIs placed on T5-T7 and L2-L4 did not significantly differ among the patients with regard to their progression to symptomatic MM and length of TTP, except for the gray-level zone length matrix-short-zone low-gray-level emphasis and gray-level zone length matrix-low gray-level zone emphasis. Particularly, second- and higher order texture features showed a significant association with the above-mentioned outcomes.
Texture features derived from PET may be an expression of subtle disease distribution in the axial and peripheral bone marrow.
这项回顾性研究聚焦于纹理分析得出的PET参数在冒烟型多发性骨髓瘤患者中的潜在临床意义。若干纹理特征与进展为有症状的多发性骨髓瘤以及较短的进展时间显著相关。本研究结果可能有助于早期识别可从特定治疗中获益的患者。
本研究的目的是确定在未发现18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）有局灶性F-FDG摄取部位的情况下，从轴向和外周骨骼纹理分析得出的正电子发射断层扫描参数是否能预测冒烟型多发性骨髓瘤（MM）进展为有症状的MM。
回顾性分析2014年5月至2018年6月期间接受F-FDG PET/CT检查的冒烟型MM患者。感兴趣区（VOIs）置于T5-T7、L2-L4、髂嵴和股骨干。专用软件（LIFEx）使我们能够获取PET衍生的一阶、二阶和高阶纹理特征。确定PET参数与进展为有症状MM之间的可能关联。Kaplan-Meier曲线用于根据PET参数评估进展时间（TTP）。
纳入45例患者：26例（58%）未达到有症状MM的标准，但19例（42%）进展为有症状MM。从置于髂嵴和股骨干的VOIs提取的若干纹理特征与进展为有症状MM以及较短的TTP显著相关（P < 0.05）；相反，从置于T5-T7和L2-L4的VOIs提取的上述参数在进展为有症状MM的患者及其TTP长度方面无显著差异，除了灰度级区域长度矩阵-短区域低灰度级强调和灰度级区域长度矩阵-低灰度级区域强调。特别是，二阶和高阶纹理特征与上述结果显著相关。
PET衍生的纹理特征可能是轴向和外周骨髓中细微疾病分布的一种表现。
