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Radiomic analysis using density threshold for FDG-PET/CT-based N-staging in lung cancer patients

: Flechsig, P.; Frank, P.; Kratochwil, C.; Antoch, G.; Rath, D.; Moltz, J.; Rieser, M.; Warth, A.; Kauczor, H.-U.; Schwartz, L.H.; Haberkorn, U.; Giesel, F.L.


Molecular imaging and biology 19 (2017), Nr.2, S.315-322
ISSN: 1536-1632
ISSN: 1860-2002
Fraunhofer MEVIS ()

Purpose: Mediastinal nodal (N)-staging done by integrated 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) positron emission tomography/x-ray computed tomography (PET/CT) in lung cancer patients is not always accurate. In order to reduce the need for invasive staging procedures, additional surrogate parameters for the detection of malignant lymph node infiltration would be helpful. The purpose of this study was to evaluate if radiomic semi-automated density profiling in mediastinal lymph nodes can improve preclinical N-staging, irrespective of the specific lung cancer entity.
Procedures: This retrospective study was approved by the institutional review board. Two hundred forty-eight histologically proven lymph nodes in 122 lung cancer patients were investigated. In malignantly infiltrated lymph nodes, the specific lung cancer entity was histologically classified; benign lymph nodes were histologically classified as benign. Non-contrast enhanced [18F]FDG-PET/CT was performed before surgery/biopsy.