Clinical utility of texture analysis of 18F-FDG PET/CT in patients with Stage I lung cancer treated with stereotactic body radiotherapy

We evaluated the reproducibility and predictive value of texture parameters and existing parameters of 18f-fdg pet/ct images in stage i non-small-cell lung cancer (nsclc) patients treated with stereotactic body radiotherapy (sbrt). twenty-six patients with stage i nsclc (t1-2n0m0) were retrospectively analyzed. all of the patients underwent an 18f-fdg pet/ct scan before treatment and were treated with sbrt. each tumor was delineated using pet edge (mim software inc.,cleveland,oh),and texture parameters were calculated using open-source code cgita. from 18f-fdg pet/ct images,three conventional parameters,including maximum standardized uptake value (suv),metabolic tumor volume (mtv) and total lesion glycolysis (tlg),and four texture parameters,including entropy and dissimilarity (derived from a co-occurrence matrix) and high-intensity large-area emphasis (hilae) and zone percentage (derived from a size-zone matrix) were analyzed. reproducibility was evaluated using two independent delineations conducted by two observers. the ability to predict local control (lc),progression-free survival (pfs) and overall survival (os) was tested for each parameter. all of the seven parameters except zone percentage showed good reproducibility,with intraclass correlation coefficient values >0.8. in univariate analysis,only hilae was a significant predictor for lc. histology,dose fractionation,and maximum suv were associated with pfs,and histology and dose fractionation were associated with os. we showed that texture parameters derived from 18f-fdg pet/ct were reproducible and potentially beneficial for predicting lc in stage i lung cancer patients treated with sbrt. © the author 2017.