Correlations between metabolic texture features, genetic heterogeneity, and mutation burden in patients with lung cancer
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This study investigated the correlations between parameters of 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan and indices of genetic properties, heterogeneity index (HI), and tumor mutation burden (TMB), in patients with lung cancer.
We produced 106 PET indices for each tumor site that underwent genomic analysis in a total of 176 study subjects (age, 62.0 ± 10.0 y; males, 68.2%), comprising 101 adenocarcinoma (ADC), 29 squamous cell carcinoma (SQCC), and 46 small cell lung cancer (SCLC) patients. We then examined the correlations of the PET parameters with genetic properties of HI and TMB, according to pathology and tumor site.
Comparisons between PET parameters and the genetic properties with false discovery rate (FDR) correction revealed that the surface standard uptake value (SUV) entropy of SUV statistics had a significant correlation with HI only in patients with SCLC who underwent a genetic test in lymph nodes (r = 0.592, p = 0.028), whereas PET parameters did not show a significant correlation with HI or TMB in patients with SCLC who underwent a genetic test in lung tissue. In patients with ADC and SQCC, there was no significant correlation between PET parameters and the genetic properties. Although SUVmax showed raw p values less than 0.05 in correlation with HI (r = 0.315, raw p = 0.048) and TMB (r = 0.206, raw p = 0.043) in ADC, and SUVpeak had a raw p value less than 0.05 in correlation with HI (r = 0.394, raw p = 0.046) in SQCC, these parameters were not significant when corrected by FDR.
In this study, surface SUV entropy had a significant correlation with HI in SCLC. Regarding other PET parameters and tumors, no significant correlation with genetic parameters existed.
Keywords18F-fluorodeoxyglucose (FDG) Positron emission tomography (PET) Imaging genomics Genetic heterogeneity Tumor mutation burden
The authors thank Kyunga Kim and Min-Ji Kim from the Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center for their important contributions to our statistical analysis. They also thank Yu-Hua Fang from Department of Biomedical Engineering, National Cheng Kung University and Hongyoon Choi from Department of Nuclear Medicine, Seoul National University Hospital for their important contributions to our imaging analysis.
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No.NRF-2016R1C1B2013411).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
The institutional review board approved that the requirement for written informed consents were waived in this study.
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