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Insights into Imaging
Published in: Insights into Imaging 1/2023

Open Access 01-12-2023 | Pulmonary Nodule | Original Article

Radiomic analysis will add differential diagnostic value of benign and malignant pulmonary nodules: a hybrid imaging study based on [18F]FDG and [18F]FLT PET/CT

Authors: Jing Ning, Can Li, Peng Yu, Jingjing Cui, Xiaodan Xu, Yan Jia, Panli Zuo, Jiahe Tian, Lukas Kenner, Baixuan Xu

Published in: Insights into Imaging | Issue 1/2023

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Abstract

Purpose

To investigate the clinical value of radiomic analysis on [18F]FDG and [18F]FLT PET on the differentiation of [18F]FDG-avid benign and malignant pulmonary nodules (PNs).

Methods

Data of 113 patients with inconclusive PNs based on preoperative [18F]FDG PET/CT who underwent additional [18F]FLT PET/CT scans within a week were retrospectively analyzed in the present study. Three methods of analysis including visual analysis, radiomic analysis based on [18F]FDG PET/CT images alone, and radiomic analysis based on dual-tracer PET/CT images were evaluated for differential diagnostic value of benign and malignant PNs.

Results

A total of 678 radiomic features were extracted from volumes of interest (VOIs) of 123 PNs. Fourteen valuable features were thereafter selected. Based on a visual analysis of [18F]FDG PET/CT images, the diagnostic accuracy, sensitivity, and specificity were 61.6%, 90%, and 28.8%, respectively. For the test set, the area under the curve (AUC), sensitivity, and specificity of the radiomic models based on [18F]FDG PET/CT plus [18F]FLT signature were equal or better than radiomics based on [18F]FDG PET/CT only (0.838 vs 0.810, 0.778 vs 0.778, 0.750 vs 0.688, respectively).

Conclusion

Radiomic analysis based on dual-tracer PET/CT images is clinically promising and feasible for the differentiation between benign and malignant PNs.

Clinical relevance statement

Radiomic analysis will add differential diagnostic value of benign and malignant pulmonary nodules: a hybrid imaging study based on [18F]FDG and [18F]FLT PET/CT.

Key points

• Radiomics brings new insights into the differentiation of benign and malignant pulmonary nodules beyond the naked eyes.
• Dual-tracer imaging shows the biological behaviors of cancerous cells from different aspects.
• Radiomics helps us get to the histological view in a non-invasive approach.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
Radiomic analysis will add differential diagnostic value of benign and malignant pulmonary nodules: a hybrid imaging study based on [18F]FDG and [18F]FLT PET/CT
Authors
Jing Ning
Can Li
Peng Yu
Jingjing Cui
Xiaodan Xu
Yan Jia
Panli Zuo
Jiahe Tian
Lukas Kenner
Baixuan Xu
Publication date
01-12-2023
Publisher
Springer Vienna
Published in
Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-023-01530-6

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