Radiomic Features Associated with Lymphoma Development in the Parotid Glands of Patients with Primary Sjögren's Syndrome

Delia Doris Muntean; Lavinia Manuela Lenghel; Paul Andrei Ștefan; Daniela Fodor; Maria Bădărînză; Csaba Csutak; Sorin Marian Dudea; Georgeta Mihaela Rusu

doi:10.3390/cancers15051380

Radiomic Features Associated with Lymphoma Development in the Parotid Glands of Patients with Primary Sjögren's Syndrome

Cancers (Basel). 2023 Feb 22;15(5):1380. doi: 10.3390/cancers15051380.

Authors

Delia Doris Muntean¹, Lavinia Manuela Lenghel¹, Paul Andrei Ștefan^{2

3}, Daniela Fodor⁴, Maria Bădărînză⁴, Csaba Csutak¹, Sorin Marian Dudea¹, Georgeta Mihaela Rusu¹

Affiliations

¹ Radiology Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
² Anatomy and Embryology, Morphological Sciences Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
³ Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, General Hospital of Vienna (AKH), Waehringer Guertel 18-20, 1090 Vienna, Austria.
⁴ 2nd Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania.

Abstract

Non-Hodgkin Lymphoma (NHL) represents a severe complication and the main cause of morbidity in patients with primary Sjögren's syndrome (pSS). This study aimed to assess the role of textural analysis (TA) in revealing lymphoma-associated imaging parameters in the parotid gland (PG) parenchyma of patients with pSS. This retrospective study included a total of 36 patients (54.93 ± 13.34 years old; 91.6% females) diagnosed with pSS according to the American College of Rheumatology and the European League Against Rheumatism criteria (24 subjects with pSS and no lymphomatous proliferation; 12 subjects with pSS and NHL development in the PG, confirmed by the histopathological analysis). All subjects underwent MR scanning between January 2018 and October 2022. The coronal STIR PROPELLER sequence was employed to segment PG and perform TA using the MaZda5 software. A total of 65 PGs underwent segmentation and texture feature extraction (48 PGs were included in the pSS control group, and 17 PGs were included in the pSS NHL group). Following parameter reduction techniques, univariate analysis, multivariate regression, and receiver operating characteristics (ROC) analysis, the following TA parameters proved to be independently associated with NHL development in pSS: CH4S6_Sum_Variance and CV4S6_Inverse_Difference_Moment, with an area under ROC of 0.800 and 0.875, respectively. The radiomic model (resulting by combining the two previously independent TA features), presented 94.12% sensitivity and 85.42% specificity in differentiating between the two studied groups, reaching the highest area under ROC of 0.931 for the chosen cutoff value of 1.556. This study suggests the potential role of radiomics in revealing new imaging biomarkers that might serve as useful predictors for lymphoma development in patients with pSS. Further research on multicentric cohorts is warranted to confirm the obtained results and the added benefit of TA in risk stratification for patients with pSS.

Keywords: MRI; lymphoma; primary Sjögren’s syndrome; radiomics; textural analysis.

Grants and funding

This work was granted by project PDI-PFE-CDI 2021, entitled Increasing the Performance of Scientific Research, Supporting Excellence in Medical Research and Innovation, PROGRES, no. 40PFE/30 December 2021.