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. 2022 Oct 9;23(19):11985.
doi: 10.3390/ijms231911985.

Predicting the Recurrence of Gastric Cancer Using the Textural Features of Perigastric Adipose Tissue on [18F]FDG PET/CT

Hyein Ahn  1 , Geum Jong Song  2 , Si-Hyong Jang  1 , Myoung Won Son  2 , Hyun Ju Lee  1 , Moon-Soo Lee  2 , Ji-Hye Lee  1 , Mee-Hye Oh  1 , Geum Cheol Jeong  3 , Jong Hyuk Yun  2 , Sang Mi Lee  3 , Jeong Won Lee  4
Affiliations

Predicting the Recurrence of Gastric Cancer Using the Textural Features of Perigastric Adipose Tissue on [18F]FDG PET/CT

Hyein Ahn et al. Int J Mol Sci. .

Abstract

This study aimed to assess the relationship between the histopathological and textural features of perigastric adipose tissue (AT) on 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) and to evaluate the prognostic significance of perigastric AT textural features in predicting recurrence-free survival (RFS) in patients with gastric cancer. Sixty-nine patients with gastric cancer who underwent staging [18F]FDG PET/CT and subsequent curative surgery were retrospectively reviewed. Textural features of perigastric AT were extracted from PET images. On histopathological analysis, CD4, CD8, and CD163 cell infiltration and matrix metalloproteinase-11 and interleukin-6 (IL-6) expression in perigastric AT were graded. The degree of CD163 cell infiltration in perigastric AT was significantly correlated with the mean standardized uptake value (SUV), SUV histogram entropy, grey-level co-occurrence matrix (GLCM) energy, and GLCM entropy of perigastric AT. The degree of IL-6 expression in the perigastric AT was significantly correlated with the mean and median SUVs of perigastric AT. In multivariate survival analysis, GLCM entropy, GLCM dissimilarity, and GLCM homogeneity of perigastric AT were significant predictors of RFS. The textural features of perigastric AT on [18F]FDG PET/CT significantly correlated with inflammatory response in perigastric AT and were significant prognostic factors for predicting RFS in patients with gastric cancer.

Keywords: F-18 fluorodeoxyglucose; adipose tissue; positron emission tomography; stomach neoplasm; textural feature.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Cumulative recurrence-free survival curves based on the GLCM dissimilarity (a), GLCM entropy (b), and GLCM homogeneity (c) of perigastric AT.
Figure 2
Figure 2
Maximal intensity projection image (a) and transaxial images (b,c) of [18F]FDG PET/CT illustrating VOI for measuring textural features of perigastric AT. A 59-year-old man underwent [18F]FDG PET/CT for staging work-up of gastric cancer in the stomach body. The gastric cancer lesion showed intensely increased [18F]FDG with the maximum SUV of 17.99 (arrows on (a,b)). A VOI that covers the area within a 1 cm distance to the margin of primary gastric cancer was manually drawn, and perigastric AT was defined as an area of CT-attenuation range between −190 HU and −30 HU within the VOI (red area in (c). The mean SUV, GLCM homogeneity, GLCM entropy, and GLCM dissimilarity of the perigastric AT were 1.05, 0.74, 3.01, and 0.49, respectively. The patient underwent total gastrectomy and was diagnosed with pT2N0 stage moderately differentiated tubular adenocarcinoma. The patient had cancer recurrence 23.9 months after the surgery.
Figure 3
Figure 3
Representative images of immunohistochemical analyses of the perigastric AT. Immunohistochemical staining of CD4 (a,f), CD8 (b,g), CD163 (c,h), MMP-11 (d,i), and IL-6 (e,j). Examples of a score range of 0–1 are shown in (a–e), and examples of a score range of 2–3 area shown in (f–j). The magnifications of all images were 200×.
Figure 4
Figure 4
Schematic flowchart of the overall workflow.
See this image and copyright information in PMC

References

    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J. Clin. 2021;71:209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Japanese Gastric Cancer Association Japanese gastric cancer treatment guidelines 2018 (5th edition) Gastric Cancer. 2021;24:1–21. doi: 10.1007/s10120-020-01042-y. - DOI - PMC - PubMed
    1. Guo J., Xu A., Sun X., Zhao X., Xia Y., Rao H., Zhang Y., Zhang R., Chen L., Zhang T., et al. Three-year outcomes of the randomized phase III SEIPLUS trial of extensive intraoperative peritoneal lavage for locally advanced gastric cancer. Nat. Commun. 2021;12:6598. doi: 10.1038/s41467-021-26778-8. - DOI - PMC - PubMed
    1. Qiu W.-W., Chen Q.-Y., Zheng W.-Z., He Q.-C., Huang Z.-N., Xie J.-W., Wang J.-B., Lin J.-X., Lu J., Cao L.-L., et al. Postoperative follow-up for gastric cancer needs to be individualized according to age, tumour recurrence pattern, and recurrence time. Eur. J. Surg. Oncol. 2022;48:1790–1798. doi: 10.1016/j.ejso.2022.02.025. - DOI - PubMed
    1. Lee J.W., Lee S.M., Lee M.-S., Shin H.C. Role of 18F-FDG PET/CT in the prediction of gastric cancer recurrence after curative surgical resection. Eur. J. Pediatr. 2012;39:1425–1434. doi: 10.1007/s00259-012-2164-2. - DOI - PubMed