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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 3/2015

01-03-2015 | Original Article

Zone-size nonuniformity of 18F-FDG PET regional textural features predicts survival in patients with oropharyngeal cancer

Authors: Nai-Ming Cheng, Yu-Hua Dean Fang, Li-yu Lee, Joseph Tung-Chieh Chang, Din-Li Tsan, Shu-Hang Ng, Hung-Ming Wang, Chun-Ta Liao, Lan-Yan Yang, Ching-Han Hsu, Tzu-Chen Yen

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2015

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Abstract

Purpose

The question as to whether the regional textural features extracted from PET images predict prognosis in oropharyngeal squamous cell carcinoma (OPSCC) remains open. In this study, we investigated the prognostic impact of regional heterogeneity in patients with T3/T4 OPSCC.

Methods

We retrospectively reviewed the records of 88 patients with T3 or T4 OPSCC who had completed primary therapy. Progression-free survival (PFS) and disease-specific survival (DSS) were the main outcome measures. In an exploratory analysis, a standardized uptake value of 2.5 (SUV 2.5) was taken as the cut-off value for the detection of tumour boundaries. A fixed threshold at 42 % of the maximum SUV (SUVmax 42 %) and an adaptive threshold method were then used for validation. Regional textural features were extracted from pretreatment 18F-FDG PET/CT images using the grey-level run length encoding method and grey-level size zone matrix. The prognostic significance of PET textural features was examined using receiver operating characteristic (ROC) curves and Cox regression analysis.

Results

Zone-size nonuniformity (ZSNU) was identified as an independent predictor of PFS and DSS. Its prognostic impact was confirmed using both the SUVmax 42 % and the adaptive threshold segmentation methods. Based on (1) total lesion glycolysis, (2) uniformity (a local scale texture parameter), and (3) ZSNU, we devised a prognostic stratification system that allowed the identification of four distinct risk groups. The model combining the three prognostic parameters showed a higher predictive value than each variable alone.

Conclusion

ZSNU is an independent predictor of outcome in patients with advanced T-stage OPSCC, and may improve their prognostic stratification.
Appendix
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Metadata
Title
Zone-size nonuniformity of 18F-FDG PET regional textural features predicts survival in patients with oropharyngeal cancer
Authors
Nai-Ming Cheng
Yu-Hua Dean Fang
Li-yu Lee
Joseph Tung-Chieh Chang
Din-Li Tsan
Shu-Hang Ng
Hung-Ming Wang
Chun-Ta Liao
Lan-Yan Yang
Ching-Han Hsu
Tzu-Chen Yen
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-014-2933-1

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