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

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

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Abstract

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.

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.

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.

Original languageEnglish
Pages (from-to)419-428
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume42
Issue number3
DOIs
Publication statusPublished - 2015 Jan 1

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All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Cheng, N. M., Fang, Y. H. D., Lee, L. Y., Chang, J. T. C., Tsan, D. L., Ng, S. H., Wang, H. M., Liao, C. T., Yang, L. Y., Hsu, C. H., & Yen, T. C. (2015). Zone-size nonuniformity of 18F-FDG PET regional textural features predicts survival in patients with oropharyngeal cancer. European Journal of Nuclear Medicine and Molecular Imaging, 42(3), 419-428. https://doi.org/10.1007/s00259-014-2933-1