Nuclear Medicine and PET/CT Centre, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Faculty of Biomedical Sciences, Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland.
Hematol Oncol. 2022 Feb;40(1):11-21. doi: 10.1002/hon.2935. Epub 2021 Oct 29.
Functional parameters from positron emission tomography (PET) seem promising biomarkers in various lymphoma subtypes. This study investigated the prognostic value of PET radiomics in diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP given either every 14 (testing set) or 21 days (validation set). Using the PyRadiomics Python package, 107 radiomics features were extracted from baseline PET scans of 133 patients enrolled in the Swiss Group for Clinical Cancer Research 38/07 prospective clinical trial (SAKK 38/07) [ClinicalTrial.gov identifier: NCT00544219]. The international prognostic indices, the main clinical parameters and standard PET metrics, together with 52 radiomics uncorrelated features (selected using the Spearman correlation test) were included in a least absolute shrinkage and selection operator (LASSO) Cox regression to assess their impact on progression-free (PFS), cause-specific (CSS), and overall survival (OS). A linear combination of the resulting parameters generated a prognostic radiomics score (RS) whose area under the curve (AUC) was calculated by receiver operating characteristic analysis. The RS efficacy was validated in an independent cohort of 107 DLBCL patients. LASSO Cox regression identified four radiomics features predicting PFS in SAKK 38/07. The derived RS showed a significant capability to foresee PFS in both testing (AUC, 0.709; p < 0.001) and validation (AUC, 0.706; p < 0.001) sets. RS was significantly associated also with CSS and OS in testing (CSS: AUC, 0.721; p < 0.001; OS: AUC, 0.740; p < 0.001) and validation (CSS: AUC, 0.763; p < 0.0001; OS: AUC, 0.703; p = 0.004) sets. The RS allowed risk classification of patients with significantly different PFS, CSS, and OS in both cohorts showing better predictive accuracy respect to clinical international indices. PET-derived radiomics may improve the prediction of outcome in DLBCL patients.
正电子发射断层扫描（PET）的功能参数似乎是各种淋巴瘤亚型有前途的生物标志物。本研究调查了 PET 放射组学在接受 R-CHOP 治疗的弥漫性大 B 细胞淋巴瘤（DLBCL）患者中的预后价值，R-CHOP 每 14 天（测试集）或 21 天（验证集）给药。使用 PyRadiomics Python 包，从瑞士临床癌症研究组 38/07 前瞻性临床试验（SAKK 38/07）[ClinicalTrial.gov 标识符：NCT00544219]入组的 133 名患者的基线 PET 扫描中提取了 107 个放射组学特征。国际预后指数、主要临床参数和标准 PET 指标，以及 52 个放射组学不相关特征（使用斯皮尔曼相关性检验选择），均被纳入最小绝对收缩和选择算子（LASSO）Cox 回归，以评估它们对无进展生存期（PFS）、特异性生存期（CSS）和总生存期（OS）的影响。通过接收器工作特征分析计算生成的参数的线性组合生成预后放射组学评分（RS）。在 107 名 DLBCL 患者的独立队列中验证了 RS 的疗效。LASSO Cox 回归确定了 SAKK 38/07 中预测 PFS 的四个放射组学特征。所得到的 RS 在测试集（AUC，0.709;p<0.001）和验证集（AUC，0.706;p<0.001）中均具有显著的预测 PFS 能力。在测试集（CSS：AUC，0.721;p<0.001;OS：AUC，0.740;p<0.001）和验证集（CSS：AUC，0.763;p<0.0001;OS：AUC，0.703;p=0.004）中，RS 与 CSS 和 OS 也显著相关。RS 允许对两个队列中的患者进行 PFS、CSS 和 OS 的风险分类，与临床国际指数相比，具有更高的预测准确性。PET 衍生的放射组学可能会提高对 DLBCL 患者结局的预测能力。
