Lee Hyunjong, Kim Hojoong, Choi Yong Soo, Pyo Hong Ryul, Ahn Myung-Ju, Choi Joon Young
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Cancers (Basel). 2022 Aug 5;14(15):3809. doi: 10.3390/cancers14153809.
Texture analysis provides image parameters from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Although some parameters are associated with tumor biology and clinical features, the types and implications of these parameters are complicated. We applied pseudotime analysis, which has recently been used to estimate changes in individual sample characteristics, to texture parameters from FDG PET/CT images of locally advanced non-small-cell lung cancer (NSCLC) patients undergoing neoadjuvant concurrent chemoradiation therapy (CCRT) followed by surgery. Our subjects were 303 NSCLC patients who underwent pretherapeutic FDG PET/CT and tri-modality therapy. Texture parameters of the primary tumor were calculated from FDG PET/CT images acquired before neoadjuvant CCRT. Pseudotime analysis was performed using the PhenoPath tool. Clinicopathologic features including survival data were collected and survival analysis was performed to compare the prognostic significances of pseudotime parameters with those of conventional PET parameters. Pseudotime was successfully estimated from texture parameters. Normalized co-occurrence homogeneity, normalized co-occurrence inverse difference moment, and black-white symmetry showed positive correlations with pseudotime, short run emphasis, normalized co-occurrence dissimilarity, and short zone emphasis negative correlation. The maximum standardized uptake value (SUV) and mean SUV were not associated with overall survival. Pseudotime, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) showed significant associations with overall survival. In contrast to MTV and TLG, pseudotime was an independent prognostic factor for overall survival. Various metabolic texture parameters can be integrated into a single parameter using pseudotime analysis. Pseudotime of the primary tumor, estimated from FDG PET/CT images, better predicts overall survival in locally advanced NSCLC patients treated with tri-modality therapy than conventional PET parameters.
纹理分析可从F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）中提供图像参数。尽管一些参数与肿瘤生物学和临床特征相关，但其类型和意义较为复杂。我们将最近用于估计个体样本特征变化的伪时间分析应用于接受新辅助同步放化疗（CCRT）后手术的局部晚期非小细胞肺癌（NSCLC）患者的FDG PET/CT图像纹理参数。我们的研究对象为303例接受治疗前FDG PET/CT及三联疗法的NSCLC患者。原发性肿瘤的纹理参数由新辅助CCRT前获取的FDG PET/CT图像计算得出。使用PhenoPath工具进行伪时间分析。收集包括生存数据在内的临床病理特征，并进行生存分析，以比较伪时间参数与传统PET参数的预后意义。从纹理参数中成功估计出伪时间。归一化共生均匀性、归一化共生逆差矩和黑白对称性与伪时间呈正相关，短游程强调、归一化共生相异性和短区域强调呈负相关。最大标准化摄取值（SUV）和平均SUV与总生存期无关。伪时间、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）与总生存期显著相关。与MTV和TLG不同，伪时间是总生存期的独立预后因素。使用伪时间分析可将各种代谢纹理参数整合为一个单一参数。从FDG PET/CT图像估计的原发性肿瘤伪时间，比传统PET参数能更好地预测接受三联疗法治疗的局部晚期NSCLC患者的总生存期。
