Abstract
The aim of this study was to compare two different tomographs for the evaluation of the role of semiquantitative PET/CT parameters and radiomics features (RF) in the prediction of thyroid incidentalomas (TIs) at 18F-FDG imaging. A total of 221 patients with the presence of TIs were retrospectively included. After volumetric segmentation of each TI, semiquantitative parameters and RF were extracted. All of the features were tested for significant differences between the two PET scanners. The performances of all of the features in predicting the nature of TIs were analyzed by testing three classes of final logistic regression predictive models, one for each tomograph and one with both scanners together. Some RF resulted significantly different between the two scanners. PET/CT semiquantitative parameters were not able to predict the final diagnosis of TIs while GLCM-related RF (in particular GLCM entropy_log2 e GLCM entropy_log10) together with some GLRLM-related and GLZLM-related features presented the best predictive performances. In particular, GLCM entropy_log2, GLCM entropy_log10, GLZLM SZHGE, GLRLM HGRE and GLRLM HGZE resulted the RF with best performances. Our study enabled the selection of some RF able to predict the final nature of TIs discovered at 18F-FDG PET/CT imaging. Classic semiquantitative and volumetric PET/CT parameters did not reveal these abilities. Furthermore, a good overlap in the extraction of RF between the two scanners was underlined.
Highlights
Differentiated thyroid cancer (DTC) represents about 1% of all malignant tumors; it is the most frequent form of endocrine carcinoma and is usually characterized by good prognosis [1,2,3,4]
These findings suggest two relevant points: the former indicates that different sca ners can potentially have different preferred features in terms of correlations with a cli cal outcome; the second point suggests that we must critically consider radiomics mod coming from centers adopting different technologies
The results showed that the scanner technology concretely affects some radiomics features (RF), as previously underlined in literature, and in clinical day practice the use of different tomographs in the same department is frequent [20,28,29,30,31,32,33,34]
Summary
Differentiated thyroid cancer (DTC) represents about 1% of all malignant tumors; it is the most frequent form of endocrine carcinoma and is usually characterized by good prognosis [1,2,3,4]. We have been continuously experiencing an increase in the use of positron emission tomography/computed tomography (PET/CT) with 18 F-fluorodeoxyglucose (18 F-FDG) for the evaluation of various pathologies, both neoplastic and inflammatory In this context, even in the diagnostic work-up of DTC this hybrid imaging modality has a central role, in particular in the evaluation of patients with no evidence of 131I avid disease but a persistence of elevated thyroglobulin levels [4,9,10]
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