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PET/MRI and PET/CT Radiomics in Primary Cervical Cancer: A Pilot Study on the Correlation of Pelvic PET, MRI, and CT Derived Image Features

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A Publisher Correction to this article was published on 22 November 2021

This article has been updated

Abstract

Purpose

To evaluate the correlation of radiomic features in pelvic [2-deoxy-2-18F]fluoro-d-glucose positron emission tomography/magnetic resonance imaging and computed tomography ([18F]FDG PET/MRI and [18F]FDG PET/CT) in patients with primary cervical cancer (CCa).

Procedures

Nineteen patients with histologically confirmed primary squamous cell carcinoma of the cervix underwent same-day [18F]FDG PET/MRI and PET/CT. Two nuclear medicine physicians performed a consensus reading in random order. Free-hand regions of interest covering the primary cervical tumors were drawn on PET, contrast-enhanced pelvic CT, and pelvic MR (T2 weighted and ADC) images. Several basic imaging features, standard uptake values (SUVmean, SUVmax, and SUVpeak), total lesion glycolysis (TLG), metabolic tumor volume (MTV), and more advanced texture analysis features were calculated. Pearson’s correlation test was used to assess the correlation between each pair of features. Features were compared between local and metastatic tumors, and their role in predicting metastasis was evaluated by receiver operating characteristic curves.

Results

For a total of 101 extracted features, 1104/5050 pairs of features showed a significant correlation (ρ ≥ 0.70, p < 0.05). There was a strong correlation between 190/484 PET pairs of features from PET/MRI and PET/CT, 91/418 pairs of CT and PET from PET/CT, 79/418 pairs of T2 and PET from PET/MRI, and 50/418 pairs of ADC and PET from PET/MRI. Significant difference was seen between eight features in local and metastatic tumors including MTV, TLG, and entropy on PET from PET/CT; MTV and TLG on PET from PET/MRI; compactness and entropy on T2; and entropy on ADC images.

Conclusions

We demonstrated strong correlation of many extracted radiomic features between PET/MRI and PET/CT. Eight radiomic features calculated on PET/CT and PET/MRI were significantly different between local and metastatic CCa. This study paves the way for future studies to evaluate the diagnostic and predictive potential of radiomics that could guide clinicians toward personalized patients care.

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Change history

  • 14 November 2021

    Due to a production error, this article was updated to include the statement “Shadi A. Esfahani and Angel Torrado-Carvajal contributed equally to this manuscript.”

  • 22 November 2021

    A Correction to this paper has been published: https://doi.org/10.1007/s11307-021-01671-4

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Author information

Author notes

  1. Shadi A. Esfahani and Angel Torrado-Carvajal contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Shadi A. Esfahani, Debra Gervais & Onofrio A. Catalano

  2. Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital Boston and Harvard Medical School, Boston, MA, USA

    Shadi A. Esfahani, Angel Torrado-Carvajal & Onofrio A. Catalano

  3. Medical Image Analysis and Biometry Lab, Universidad Rey Juan Carlos, Madrid, Spain

    Angel Torrado-Carvajal

  4. Division of Nuclear Medicine, State University of Campinas (UNICAMP), Campinas, Brazil

    Barbara Juarez Amorim

  5. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    David Groshar, Liran Domachevsky & Hanna Bernstine

  6. Department of Nuclear Medicine and Radiology, Assuta Medical Centers, Tel-Aviv, Israel

    David Groshar, Liran Domachevsky, Hanna Bernstine & Dan Stein

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Contributions

S.A.E., A.T.C., D.G., L.D., H.B., D.S., D.G., B.J.A., and O.A.C. contributed to the concept and design of the study. D.G., L.D., H.B., D.S., and O.A.C. contributed to the acquisition of the data. S.A.E., A.T.C., D.G., H.B., L.D., B.J.A., D.S., D.G., and O.A.C. contributed to the analysis and interpretation of the data. S.A.E., A.T.C., and O.A.C. drafted the manuscript. All authors read, critically revised, and approved the manuscript. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Onofrio A. Catalano.

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Ethics Approval

The study has been approved by the institutional research ethics committee and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Given its retrospective nature, the institutional ethical committee waived the need of written informed consent.

Conflict of Interest

A.T.C. was partially supported by the Young Researchers R&D Project M2166 (MIMC3-PET/MR) financed by Community of Madrid and Rey Juan Carlos University. Other authors declare that they have no relevant disclosures.

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Esfahani, S.A., Torrado-Carvajal, A., Amorim, B.J. et al. PET/MRI and PET/CT Radiomics in Primary Cervical Cancer: A Pilot Study on the Correlation of Pelvic PET, MRI, and CT Derived Image Features. Mol Imaging Biol 24, 60–69 (2022). https://doi.org/10.1007/s11307-021-01658-1

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