Radiomic analysis using density threshold for FDG-PET/CT-based N-staging in lung cancer patients

• Verfasst von: Flechsig, Paul [VerfasserIn]
• Verfasst von: Frank, Philipp [VerfasserIn]
• Verfasst von: Kratochwil, Clemens [VerfasserIn]
• Verfasst von: Rath, Daniel [VerfasserIn]
• Verfasst von: Warth, Arne [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Haberkorn, Uwe [VerfasserIn]
• Verfasst von: Giesel, Frederik L. [VerfasserIn]
• Titel: Radiomic analysis using density threshold for FDG-PET/CT-based N-staging in lung cancer patients
• Verf.angabe: Paul Flechsig, Philipp Frank, Clemens Kratochwil, Gerald Antoch, Daniel Rath, Jan Moltz, Michael Rieser, Arne Warth, Hans-Ulrich Kauczor, Lawrence H. Schwartz, Uwe Haberkorn, Frederik L. Giesel
• Jahr: 2017
• Jahr des Originals: 2016
• Umfang: 8 S.
• Fussnoten: Published online: 18 August 2016 ; Gesehen am 21.08.2019
• Titel Quelle: Enthalten in: Molecular imaging & biology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 2002
• Jahr Quelle: 2017
• Band/Heft Quelle: 19(2017), 2, Seite 315-322
• ISSN Quelle: 1860-2002
• DOI: doi:10.1007/s11307-016-0996-z
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: FDG/PET-CT
• Sach-SW: Lung cancer
• Sach-SW: Radiomics
• Sach-SW: Staging
• K10plus-PPN: 1581118325

Abstract

PurposeMediastinal nodal (N)-staging done by integrated 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) in lung cancer patients is not always accurate. In order to reduce the need for invasive staging procedures, additional surrogate parameters for the detection of malignant lymph node infiltration would be helpful. The purpose of this study was to evaluate if radiomic semi-automated density profiling in mediastinal lymph nodes can improve preclinical N-staging, irrespective of the specific lung cancer entity.ProceduresThis retrospective study was approved by the institutional review board. Two hundred forty-eight histologically proven lymph nodes in 122 lung cancer patients were investigated. In malignantly infiltrated lymph nodes, the specific lung cancer entity was histologically classified; benign lymph nodes were histologically classified as benign. Non-contrast enhanced [18F]FDG-PET/CT was performed before surgery/biopsy. Lymph node analyses were performed on the basis of FDG uptake and volumetric CT histogram analysis for metric lymph node sampling.ResultsOf the 248 lymph nodes, 118 were benign, 130 malignant. Malignant lymph nodes had a significantly higher median CT density (32.4 Hounsfield units (HU) (min 5.4/max 77.5 HU)) compared to benign lymph nodes (9.3 HU (min −49.5/max 60.4 HU, p < 0.05), irrespective of the histological subtype. The discrimination between different malignant tumour subtypes by means of volumetric density analysis failed. Irrespective of the malignant subtype, a possible cutoff value of 20 HU may help differentiate between benign and malignant lymph nodes.ConclusionDensity measurements in unclear mediastinal and hilar lymph nodes with equivocal FDG uptake in PET might serve as a possible surrogate parameter for N-staging in lung cancer patients, irrespective of the specific lung cancer subtype. This could also help to find possible high yield targets in cases where invasive lymph node staging is necessary.