TY - JOUR
T1 - Radiomics in vulvar cancer: first clinical experience using 18F-FDG PET/CT images
AU - Garganese, Giorgia
AU - Pereira Arias-Bouda, Lenka M.
AU - Ieria, Francesco Pio
AU - Boellaard, Ronald
AU - Rufini, Vittoria
AU - De Geus-Oei, Lioe-Fee
AU - Scambia, Giovanni
AU - Valdés Olmos, Renato A.
AU - Giordano, Alessandro
AU - Grootjans, Willem
AU - Van Velden, Floris Hp
PY - 2018
Y1 - 2018
N2 - This study investigates whether radiomic features derived from preoperative positron emission tomography (PET) images could predict both tumor biology and prognosis in women with invasive squamous cell carcinoma of the vulva. Methods Patients were retrospectively included when they had a unifocal primary cancer of ≥ 2.6 cm in diameter, had received a preoperative 18F-Fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) scan followed by surgery and had at least six months of follow-up data. 18F-FDG-PET images were analyzed by semi-automatically drawing on the primary tumor in each PET image, followed by the extraction of 83 radiomic features. Unique radiomic features were identified by principal component analysis (PCA), after which they were compared with histopathology using non-pairwise group comparison and linear regression. Univariate and multivariate Cox regression analyses were used to correlate the identified features with progression-free survival (PFS) and overall survival (OS). Survival curves were estimated using the Kaplan-Meier method.Results Forty women were included. PCA revealed four unique radiomic features, which were not associated with histopathologic characteristics such as grading, depth of invasion, lymph-vascular space invasion and metastatic lymph nodes. No statistically significant correlation was found between the identified features and PFS. However, Moran’s I, a feature that identifies global spatial autocorrelation, was correlated with OS (P=0.03). Multivariate Cox regression analysis showed that extracapsular invasion of the metastatic lymph nodes and Moran’s I were independent prognostic factors for PFS and OS. Conclusion Our data show that PCA is usable to identify specific radiomic features. Although the identified features did not correlate strongly with tumor biology, Moran’s I was found to predict patient prognosis. Larger studies are required to establish the clinical relevance of the observed findings.
AB - This study investigates whether radiomic features derived from preoperative positron emission tomography (PET) images could predict both tumor biology and prognosis in women with invasive squamous cell carcinoma of the vulva. Methods Patients were retrospectively included when they had a unifocal primary cancer of ≥ 2.6 cm in diameter, had received a preoperative 18F-Fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) scan followed by surgery and had at least six months of follow-up data. 18F-FDG-PET images were analyzed by semi-automatically drawing on the primary tumor in each PET image, followed by the extraction of 83 radiomic features. Unique radiomic features were identified by principal component analysis (PCA), after which they were compared with histopathology using non-pairwise group comparison and linear regression. Univariate and multivariate Cox regression analyses were used to correlate the identified features with progression-free survival (PFS) and overall survival (OS). Survival curves were estimated using the Kaplan-Meier method.Results Forty women were included. PCA revealed four unique radiomic features, which were not associated with histopathologic characteristics such as grading, depth of invasion, lymph-vascular space invasion and metastatic lymph nodes. No statistically significant correlation was found between the identified features and PFS. However, Moran’s I, a feature that identifies global spatial autocorrelation, was correlated with OS (P=0.03). Multivariate Cox regression analysis showed that extracapsular invasion of the metastatic lymph nodes and Moran’s I were independent prognostic factors for PFS and OS. Conclusion Our data show that PCA is usable to identify specific radiomic features. Although the identified features did not correlate strongly with tumor biology, Moran’s I was found to predict patient prognosis. Larger studies are required to establish the clinical relevance of the observed findings.
KW - 18F-FDG PET/CT
KW - Vulvar cancer
KW - principal component analysis
KW - radiomics
KW - 18F-FDG PET/CT
KW - Vulvar cancer
KW - principal component analysis
KW - radiomics
UR - http://hdl.handle.net/10807/133667
U2 - 10.2967/jnumed.118.215889
DO - 10.2967/jnumed.118.215889
M3 - Article
SN - 0161-5505
VL - 2018
SP - N/A-N/A
JO - THE JOURNAL OF NUCLEAR MEDICINE
JF - THE JOURNAL OF NUCLEAR MEDICINE
ER -
