Abstract
This study investigates whether baseline 18F-FDG PET radiomic features can predict survival outcomes in patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively enrolled 83 patients diagnosed with DLBCL who underwent 18F-FDG PET scans before treatment. The patients were divided into the training cohort (n = 58) and the validation cohort (n = 25). Eighty radiomic features were extracted from the PET images for each patient. Least absolute shrinkage and selection operator regression were used to reduce the dimensionality within radiomic features. Cox proportional hazards model was used to determine the prognostic factors for progression-free survival (PFS) and overall survival (OS). A prognostic stratification model was built in the training cohort and validated in the validation cohort using Kaplan–Meier survival analysis. In the training cohort, run length non-uniformity (RLN), extracted from a gray level run length matrix (GLRLM), was independently associated with PFS (hazard ratio (HR) = 15.7, p = 0.007) and OS (HR = 8.64, p = 0.040). The International Prognostic Index was an independent prognostic factor for OS (HR = 2.63, p = 0.049). A prognostic stratification model was devised based on both risk factors, which allowed identification of three risk groups for PFS and OS in the training (p < 0.001 and p < 0.001) and validation (p < 0.001 and p = 0.020) cohorts. Our results indicate that the baseline 18F-FDG PET radiomic feature, RLNGLRLM, is an independent prognostic factor for survival outcomes. Furthermore, we propose a prognostic stratification model that may enable tailored therapeutic strategies for patients with DLBCL.
Highlights
Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma, accounting for approximately one-third of non-Hodgkin lymphomas [1]
The total metabolic tumor volume (MTV) derived from baseline 18F-FDG PET has been shown to be associated with survival outcomes in patients with diffuse large B-cell lymphoma (DLBCL) [7,8,9,10,11,12], and novel PET imaging-derived biomarkers may further individualize the treatment of lymphoma
Our results demonstrate that baseline 18F-FDG PET radiomics have prognostic value, and that RLNGLRLM is an independent prognostic factor for both progression-free survival (PFS) and overall survival (OS)
Summary
Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma, accounting for approximately one-third of non-Hodgkin lymphomas [1]. The cure rate of DLBCL has improved substantially due to advances in disease management, and the addition of rituximab immunotherapy to conventional cyclophosphamide, hydroxydaunorubicin (doxorubicin or epirubicin), oncovin (vincristine), and prednisolone chemotherapy (RCHOP) is effective in 60–70% of patients [2]. New prognostic factors for personalized riskadapted treatment is currently an unmet clinical need, and may improve the outcomes of patients with DLBCL. In addition to IPI, 18Ffluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is a standard imaging modality for patients with DLBLC. The total metabolic tumor volume (MTV) derived from baseline 18F-FDG PET has been shown to be associated with survival outcomes in patients with DLBCL [7,8,9,10,11,12], and novel PET imaging-derived biomarkers may further individualize the treatment of lymphoma
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