Abstract
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Objectives Nasal NK / T-cell lymphoma is an aggressive lymphoma marked by extensive necrosis and angioinvasion, most often presenting in extranodal sites, in particular the nasal or paranasal sinus region. The aim of this study was to investigate whether the textural features of pretreatment 18F-FDG PET/CT images can provide prognostic information.
Methods We conducted a retrospective analysis of the pretreatment 18F-FDG PET/CT images of patients with newly-diagnosed nasal NK/T-cell lymphoma from 2010 to 2013. The primary tumor was identified and then delineated using the 40% SUVmax thresholding method. The textural features of pretreatment 18F-FDG PET/CT images were extracted from histogram analysis, normalized gray-level cooccurrence matrix, and neighborhood gray-tone difference matrix. Difference in PET parameters between the progression group and non-progression group was assessed using the Mann-Whitney test and Receiver-operating-characteristic curves were used to identify the optimal cutoff values for the textural features. The Kaplan-Meier method was performed for prediction of overall survival. P values less than 0.05 were considered statistically significant.
Results Total 13 patients were enrolled. During the follow-up period (median 29 months), 7 patients showed disease progression and 3 patients died from the disease. Values of black-white symmetry of texture spectrum, high intensity zone emphasis, high intensity short zone emphasis and low intensity short zone emphasis based on intensity-size-zone matrix were statistically different between progression group and non-progression group and cut-off values according to ROC analysis were 2.5, 1290, 934 and 0.0008, respectively. Besides, high-intensity short-zone emphasis was a significant predictor of overall survival.
Conclusions Texture features of PET/CT image could provide prognostic information in nasal NK/T-cell lymphoma patients. High-intensity short-zone emphasis extracted from intensity-size-zone matrix might be a strong survival predictor.