The influence of the exclusion of central necrosis on [¹⁸F]FDG PET radiomic analysis

The influence of the exclusion of central necrosis on [¹⁸F]FDG PET radiomic analysis

Noortman, Wyanne A. (Leiden University Medical Center; University of Twente)
Vriens, Dennis (Leiden University Medical Center)
Mooij, C.D.Y. (TU Delft Biomechanical Engineering; Leiden University Medical Center)
Slump, Cornelis H. (University of Twente)
Aarntzen, Erik H. (Radboud University Medical Center)
van Berkel, Anouk (Radboud University Medical Center)
Timmers, Henri J.L.M. (Radboud University Medical Center)
Bussink, Johan (Radboud University Medical Center)
Meijer, Tineke W.H. (University Medical Center Groningen)
de Geus-Oei, Lioe Fee (Leiden University Medical Center; University of Twente)
van Velden, Floris H.P. (Leiden University Medical Center)

Biomechanical Engineering

2021

Background: Central necrosis can be detected on [¹⁸F]FDG PET/CT as a region with little to no tracer uptake. Currently, there is no consensus regarding the inclusion of regions of central necrosis during volume of interest (VOI) delineation for radiomic analysis. The aim of this study was to assess how central necrosis affects radiomic analysis in PET. Methods: Forty-three patients, either with non-small cell lung carcinomas (NSCLC, n = 12) or with pheochromocytomas or paragangliomas (PPGL, n = 31), were included retrospectively. VOIs were delineated with and without central necrosis. From all VOIs, 105 radiomic features were extracted. Differences in radiomic features between delineation methods were assessed using a paired t-test with Benjamini-Hochberg multiple testing correction. In the PPGL cohort, performances of the radiomic models to predict the noradrenergic biochemical profile were assessed by comparing the areas under the receiver operating characteristic curve (AUC) for both delineation methods. Results: At least 65% of the features showed significant differences between VOI_vital-tumour and VOI_gross-tumour (65%, 79% and 82% for the NSCLC, PPGL and combined cohort, respectively). The AUCs of the radiomic models were not significantly different between delineation methods. Conclusion: In both tumour types, almost two-third of the features were affected, demonstrating that the impact of whether or not to include central necrosis in the VOI on the radiomic feature values is significant. Nevertheless, predictive performances of both delineation methods were comparable. We recommend that radiomic studies should report whether or not central necrosis was included during delineation.

Central necrosis
Radiomics
Tumour delineation
[F]FDG PET/CT

http://resolver.tudelft.nl/uuid:d7484e8e-2262-4e93-be31-0864ff2b5f0b

https://doi.org/10.3390/diagnostics11071296

Diagnostics, 11 (7)

Institutional Repository

journal article

© 2021 Wyanne A. Noortman, Dennis Vriens, C.D.Y. Mooij, Cornelis H. Slump, Erik H. Aarntzen, Anouk van Berkel, Henri J.L.M. Timmers, Johan Bussink, Tineke W.H. Meijer, Lioe Fee de Geus-Oei, Floris H.P. van Velden