Abstract
Objectives The aim of this study is to explore the textural features that may identify the morphological changes in the lymphoma region and predict the prognosis of patients with primary renal lymphoma (PRL) and primary adrenal lymphoma (PAL). Methods This retrospective study comprised nineteen non-Hodgkin's lymphoma (NHL) patients undergoing 18F-FDG-PET/CT at West China Hospital from December 2013 to May 2017. 18F-FDG-PET images were reviewed independently by two board certificated radiologists of nuclear medicine, and the texture features were extracted from LifeX packages. The prognostic value of PET FDG-uptake parameters, patients' baseline characteristics, and textural parameters were analyzed using Kaplan–Meier analysis. Cox regression analysis was used to identify the independent prognostic factors among the imaging and clinical features. Results The overall survival of included patients was 18.84 ± 13.40 (mean ± SD) months. Univariate Cox analyses found that the tumor stage, GLCM (gray-level co-occurrence matrix) entropy, GLZLM_GLNU (gray-level nonuniformity), and GLZLM_ZLNU (zone length nonuniformity), values were significant predictors for OS. Among them, GLRLM_RLNU ≥216.6 demonstrated association with worse OS at multivariate analysis (HR 9.016, 95% CI 1.041–78.112, p=0.046). Conclusions The texture analysis of 18F-FDG-PET images could potentially serve as a noninvasive strategy to predict the overall survival of patients with PRL and PAL.
Highlights
Renal involvement has been reported as a common situation in patients diagnosed with non-Hodgkin’s lymphoma (NHL) [1]
Unlike secondary renal masses which arise from invasion of an adjacent lymphomatous mass, Primary renal lymphoma (PRL) usually originates from renal parenchyma and is highly aggressive due to its rapid dissemination [4]
Nine of them were alive at the end of follow-ups (December, 2017). e overall survival was 18.84 ± 13.40 months
Summary
Renal involvement has been reported as a common situation in patients diagnosed with non-Hodgkin’s lymphoma (NHL) [1]. Primary renal lymphoma (PRL), though less common than secondary renal lymphomas [2], is an important and lethal type of extranodal lymphomas [3]. It has been reported that the median survival of PRL is usually less than 1 year [4, 5], which may be attributed to the recurrence and neutropenia-related infection [6]. Primary adrenal lymphoma (PAL) is a rare form of cancer, of which fewer than 200 cases have been reported [8], and the prognosis is generally poor [9]. Despite the rare existence of PAL and PRL, it is important to shed light on the potential factors related to their prognosis to stratify treatment among individual patients
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