Pre-Operative Prediction of Mediastinal Node Metastasis Using Radiomics Model Based on 18 F-FDG PET/CT of the Primary Tumor in Non-Small Cell Lung Cancer Patients

Frontiers in Medicine

article

Kai Zheng¹  Xinrong Wang⁴  Chengzhi Jiang²  Yongxiang Tang¹  Zhihui Fang¹  Jiale Hou¹  Zehua Zhu¹  Shuo Hu¹ 

[1] Department of Nuclear Medicine, Xiangya Hospital, Central South University;Positron Emission Tomography/Computed Tomography (PET/CT) Center, Hunan Cancer Hospital;The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University;General Electric (GE) Healthcare (China);National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University;Key Laboratory of Biological Nanotechnology of National Health Commission, Xiangya Hospital, Central South University

关键词: non-small cell lung cancer;    18 F-FDG PET/CT;    radiomics analysis;    lymph node staging;    predict;    primary tumor;   

DOI  :  10.3389/fmed.2021.673876

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose: We investigated whether a fluorine-18-fluorodeoxy glucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT)-based radiomics model (RM) could predict the pathological mediastinal lymph node staging (pN staging) in patients with non-small cell lung cancer (NSCLC) undergoing surgery. Methods: A total of 716 patients with a clinicopathological diagnosis of NSCLC were included in this retrospective study. The prediction model was developed in a training cohort that consisted of 501 patients. Radiomics features were extracted from the 18 F-FDG PET/CT of the primary tumor. Support vector machine and extremely randomized trees were used to build the RM. Internal validation was assessed. An independent testing cohort contained the remaining 215 patients. The performances of the RM and clinical node staging (cN staging) in predicting pN staging (pN0 vs. pN1 and N2) were compared for each cohort. The area under the curve (AUC) of the receiver operating characteristic curve was applied to assess the model's performance. Results: The AUC of the RM [0.81 (95% CI, 0.771–0.848); sensitivity: 0.794; specificity: 0.704] for the predictive performance of pN1 and N2 was significantly better than that of cN in the training cohort [0.685 (95% CI, 0.644–0.728); sensitivity: 0.804; specificity: 0.568], ( P -value = 8.29e-07, as assessed by the Delong test). In the testing cohort, the AUC of the RM [0.766 (95% CI, 0.702–0.830); sensitivity: 0.688; specificity: 0.704] was also significantly higher than that of cN [0.685 (95% CI, 0.619–0.747); sensitivity: 0.799; specificity: 0.568], ( P = 0.0371, Delong test). Conclusions: The RM based on 18 F-FDG PET/CT has a potential for the pN staging in patients with NSCLC, suggesting that therapeutic planning could be tailored according to the predictions.

【 授权许可】

CC BY