Maximum Standardized Uptake Value of 18F-deoxyglucose PET Imaging Increases the Effectiveness of CT Radiomics in Differentiating Benign and Malignant Pulmonary Ground-Glass Nodules

Rong Niu; Jianxiong Gao; Xiaoliang Shao; Jianfeng Wang; Zhenxing Jiang; Yunmei Shi; Feifei Zhang; Yuetao Wang; Xiaonan Shao

doi:10.3389/fonc.2021.727094

Maximum Standardized Uptake Value of ¹⁸F-deoxyglucose PET Imaging Increases the Effectiveness of CT Radiomics in Differentiating Benign and Malignant Pulmonary Ground-Glass Nodules

Front Oncol. 2021 Dec 17:11:727094. doi: 10.3389/fonc.2021.727094. eCollection 2021.

Authors

Rong Niu^{1

2}, Jianxiong Gao^{1

2}, Xiaoliang Shao^{1

2}, Jianfeng Wang^{1

2}, Zhenxing Jiang³, Yunmei Shi^{1

2}, Feifei Zhang^{1

2}, Yuetao Wang^{1

2}, Xiaonan Shao^{1

2}

Affiliations

¹ Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.
² Changzhou Key Laboratory of Molecular Imaging, Changzhou, China.
³ Department of Radiology, the Third Affiliated Hospital of Soochow University, Changzhou, China.

Abstract

To investigate whether the maximum standardized uptake value (SUVmax) of ¹⁸F-deoxyglucose (FDG) PET imaging can increase the diagnostic efficiency of CT radiomics-based prediction model in differentiating benign and malignant pulmonary ground-glass nodules (GGNs). We retrospectively collected 190 GGNs from 165 patients who underwent ¹⁸F-FDG PET/CT examination from January 2012 to March 2020. Propensity score matching (PSM) was performed to select GGNs with similar baseline characteristics. LIFEx software was used to extract 49 CT radiomic features, and the least absolute shrinkage and selection operator (LASSO) algorithm was used to select parameters and establish the Rad-score. Logistic regression analysis was performed combined with semantic features to construct a CT radiomics model, which was combined with SUVmax to establish the PET + CT radiomics model. Receiver operating characteristic (ROC) was used to compare the diagnostic efficacy of different models. After PSM at 1:4, 190 GGNs were divided into benign group (n = 23) and adenocarcinoma group (n = 92). After texture analysis, the Rad-score with three CT texture features was constructed for each nodule. Compared with the Rad-score and CT radiomics model (AUC: 0.704 (95%CI: 0.562-0.845) and 0.908 (95%CI: 0.842-0.975), respectively), PET + CT radiomics model had the best diagnostic efficiency (AUC: 0.940, 95%CI: 0.889-0.990), and there was significant difference between each two of them (P = 0.001-0.030). SUVmax can effectively improve CT radiomics model performance in the differential diagnosis of benign and malignant GGNs. PET + CT radiomics might become a noninvasive and reliable method for differentiating of GGNs.

Keywords: fluorodeoxyglucose F18; lung adenocarcinoma; positron emission tomography-computed tomography; radiomics; standardized uptake value.