Evaluating Focal 18 F-FDG Uptake in Thyroid Gland with Radiomics
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ORIGINAL ARTICLE
Evaluating Focal 18F-FDG Uptake in Thyroid Gland with Radiomics Ayşegül Aksu 1
&
Nazlı Pınar Karahan Şen 1 & Emine Acar 2,3 & Gamze Çapa Kaya 1
Received: 28 March 2020 / Revised: 17 July 2020 / Accepted: 23 July 2020 # Korean Society of Nuclear Medicine 2020
Abstract Purpose The aim of this study was to evaluate the ability of 18F-FDG PET/CT texture analysis to predict the exact pathological outcome of thyroid incidentalomas. Methods 18F-FDG PET/CT images between March 2010 and September 2018 were retrospectively reviewed in patients with focal 18F-FDG uptake in the thyroid gland and who underwent fine needle aspiration biopsy from this area. The focal uptake in the thyroid gland was drawn in 3D with 40% SUVmax threshold. Features were extracted from volume of interest (VOI) using the LIFEx package. The features obtained were compared in benign and malignant groups, and statistically significant variables were evaluated by receiver operating curve (ROC) analysis. The correlation between the variables with area under curve (AUC) value over 0.7 was examined; variables with correlation coefficient less than 0.6 were evaluated with machine learning algorithms. Results Sixty patients (70% train set, 30% test set) were included in the study. In univariate analysis, a statistically significant difference was observed in 6 conventional parameters, 5 first-, and 16 second-order features between benign and malignant groups in train set (p < 0.05). The feature with the highest benign-malignant discriminating power was GLRLMRLNU (AUC:0.827). AUC value of SUVmax was calculated as 0.758. GLRLMRLNU and SUVmax were evaluated to build a model to predict the exact pathology outcome. Random forest algorithm showed the best accuracy and AUC (78.6% and 0.849, respectively). Conclusion In the differentiation of benign-malignant thyroid incidentalomas, GLRLMRLNU and SUVmax combination may be more useful than SUVmax to predict the outcome. Keywords Thyroid incidentaloma . FDG . PET . Radiomics . Texture
Introduction
* Ayşegül Aksu [email protected] Nazlı Pınar Karahan Şen [email protected] Emine Acar [email protected] Gamze Çapa Kaya [email protected] 1
Department of Nuclear Medicine, School of Medicine, Dokuz Eylul University, İzmir, Turkey
2
Department of Nuclear Medicine, Kent Hospital, İzmir, Turkey
3
Department of Translational Oncology, Institute of Health Sciences, Dokuz Eylul University, İzmir, Turkey
Especially in the field of oncology, with the increase in the use of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), an increase in the detection of some unexpected lesions is observed in whole body imaging [1]. Thyroid incidentaloma is a thyroid lesion detected in non-thyroid imaging. Benign-malignant differentiation of focal 18F-FDG uptake in thyroid gland in PET/CT is important for both clinicians and nuclear medicine physicians. For this purpose, the most studied parameter is the standard uptake value (SUV). In many studies, there was
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