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. 2023 Jun 30;15(13):3439.
doi: 10.3390/cancers15133439.

Prediction of 2-[18F]FDG PET-CT SUVmax for Adrenal Mass Characterization: A CT Radiomics Feasibility Study

Arnaldo Stanzione  1 , Renato Cuocolo  2 , Claudia Bombace  1 , Ilaria Pesce  1 , Ciro Gabriele Mainolfi  1 , Marco De Giorgi  1 , Gregorio Delli Paoli  1 , Pasquale La Selva  1 , Jessica Petrone  1 , Luigi Camera  1 , Michele Klain  1 , Silvana Del Vecchio  1 , Alberto Cuocolo  1 , Simone Maurea  1
Affiliations

Prediction of 2-[18F]FDG PET-CT SUVmax for Adrenal Mass Characterization: A CT Radiomics Feasibility Study

Arnaldo Stanzione et al. Cancers (Basel). .

Abstract

Background: Indeterminate adrenal masses (AM) pose a diagnostic challenge, and 2-[18F]FDG PET-CT serves as a problem-solving tool. Aim of this study was to investigate whether CT radiomics features could be used to predict the 2-[18F]FDG SUVmax of AM.

Methods: Patients with AM on 2-[18F]FDG PET-CT scan were grouped based on iodine contrast injection as CT contrast-enhanced (CE) or CT unenhanced (NCE). Two-dimensional segmentations of AM were manually obtained by multiple operators on CT images. Image resampling and discretization (bin number = 16) were performed. 919 features were calculated using PyRadiomics. After scaling, unstable, redundant, and low variance features were discarded. Using linear regression and the Uniform Manifold Approximation and Projection technique, a CT radiomics synthetic value (RadSV) was obtained. The correlation between CT RadSV and 2-[18F]FDG SUVmax was assessed with Pearson test.

Results: A total of 725 patients underwent PET-CT from April 2020 to April 2021. In 150 (21%) patients, a total of 179 AM (29 bilateral) were detected. Group CE consisted of 84 patients with 108 AM (size = 18.1 ± 4.9 mm) and Group NCE of 66 patients with 71 AM (size = 18.5 ± 3.8 mm). In both groups, 39 features were selected. No statisticallyf significant correlation between CT RadSV and 2-[18F]FDG SUVmax was found (Group CE, r = 0.18 and p = 0.058; Group NCE, r = 0.13 and p = 0.27).

Conclusions: It might not be feasible to predict 2-[18F]FDG SUVmax of AM using CT RadSV. Its role as a problem-solving tool for indeterminate AM remains fundamental.

Keywords: PET-CT; SUVmax; adrenal glands; neoplasms; radiomics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Segmentation example for unenhanced (A,B) and contrast-enhanced (C,D) CT. Images on axial plane with ROIs in red.
Figure 2
Figure 2
Plot for the linear regression model in the contrast-enhanced CT group.
Figure 3
Figure 3
Plot for the linear regression model in the unenhanced CT group.
See this image and copyright information in PMC

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