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Published in: European Radiology 7/2021

01-07-2021 | Prostate Cancer | Nuclear Medicine

Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning feature classification in 94 patients

Authors: Pierpaolo Alongi, Alessandro Stefano, Albert Comelli, Riccardo Laudicella, Salvatore Scalisi, Giuseppe Arnone, Stefano Barone, Massimiliano Spada, Pierpaolo Purpura, Tommaso Vincenzo Bartolotta, Massimo Midiri, Roberto Lagalla, Giorgio Russo

Published in: European Radiology | Issue 7/2021

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Abstract

Objective

The aim of this study was (1) to investigate the application of texture analysis of choline PET/CT images in prostate cancer (PCa) patients and (2) to propose a machine-learning radiomics model able to select PET features predictive of disease progression in PCa patients with a same high-risk class at restaging.

Material and methods

Ninety-four high-risk PCa patients who underwent restaging Cho-PET/CT were analyzed. Follow-up data were recorded for a minimum of 13 months after the PET/CT scan. PET images were imported in LIFEx toolbox to extract 51 features from each lesion. A statistical system based on correlation matrix and point-biserial-correlation coefficient has been implemented for features reduction and selection, while Discriminant analysis (DA) was used as a method for features classification in a whole sample and sub-groups for primary tumor or local relapse (T), nodal disease (N), and metastatic disease (M).

Results

In the whole group, 2 feature (HISTO_Entropy_log10; HISTO_Energy_Uniformity) results were able to discriminate the occurrence of disease progression at follow-up, obtaining the best performance in DA classification (sensitivity 47.1%, specificity 76.5%, positive predictive value (PPV) 46.7%, and accuracy 67.6%). In the sub-group analysis, the best performance in DA classification for T was obtained by selecting 3 features (SUVmin; SHAPE_Sphericity; GLCM_Correlation) with a sensitivity of 91.6%, specificity 84.1%, PPV 79.1%, and accuracy 87%; for N by selecting 2 features (HISTO = _Energy Uniformity; GLZLM_SZLGE) with a sensitivity of 68.1%, specificity 91.4%, PPV 83%, and accuracy 82.6%; and for M by selecting 2 features (HISTO_Entropy_log10 - HISTO_Entropy_log2) with a sensitivity 64.4%, specificity 74.6%, PPV 40.6%, and accuracy 72.5%.

Conclusion

This machine learning model demonstrated to be feasible and useful to select Cho-PET features for T, N, and M with valuable association with high-risk PCa patients’ outcomes.

Key Points

Artificial intelligence applications are feasible and useful to select Cho-PET features.
Our model demonstrated the presence of specific features for T, N, and M with valuable association with high-risk PCa patients’ outcomes.
Further prospective studies are necessary to confirm our results and to develop the application of artificial intelligence in PET imaging of PCa.
Literature
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Metadata
Title
Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning feature classification in 94 patients
Authors
Pierpaolo Alongi
Alessandro Stefano
Albert Comelli
Riccardo Laudicella
Salvatore Scalisi
Giuseppe Arnone
Stefano Barone
Massimiliano Spada
Pierpaolo Purpura
Tommaso Vincenzo Bartolotta
Massimo Midiri
Roberto Lagalla
Giorgio Russo
Publication date
01-07-2021
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07617-8

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