Comparison Of The Difference Of ¹⁸F-FDG PET Images Heterogeneity In Lung Adenocarcinoma And Squamous Cell Carcinoma

Objective Texture analysis on ¹⁸F-FDG PET scan is a potential image analysis tool to predict tumor response of chemo/radiotherapy and being associated with patient survival in non-small cell lung cancer?NSCLC?.However,the effect of the mixed histopathological type and staging in ¹⁸F-FDG PET image heterogeneity are still unknown.This study investigated the difference of ¹⁸F-FDG PET images heterogeneity in stage ?-? lung adenocarcinoma?ADC?and squamous cell carcinoma?SCC?,which laid the foundation for further clinical application.Methods Stage?-??AJCC seventh edition?lung adenocarcinoma and squamous cell carcinoma patients before treatment of our hospital of ¹⁸F-FDG PET / CT imagingwere retrospectively reviewed.The ¹⁸F-FDG PET DICOM data were introduced into the Matlab platform.Regions of interest were segmented manually by a standard uptake values?SUV?threshold of 2.5.The parameters of the target were obtained by the CGITA image heterogeneity analysis plug-in.We obtained fifty-three texture parameters describing global?5?,local?26?,regional?22?features and metabolic parameters: SUVs?SUVmax,SUVmean,SUVmin,SUVpeak?,metabolic tumor volume?MTV?,total lesion glycolysis?TLG?.The difference between the parameters of lung squamous cell carcinoma and adenocarcinoma was determined by absolute difference,relative difference and parameter ratio.SPSS 20.0 software was used for the following statistical analysis:1.Spearman rank correlation test was evaluated the correlation between the above parameters and clinical stage;2.The difference of parameters between lung adenocarcinoma and squamous cell carcinoma in the overall of stage?-? was used M-W U analysis;3.The difference of parameters between lung adenocarcinoma and squamous cell carcinoma in the each staging was used by K-W H analysis.4.The changing of the parameters of lung adenocarcinoma and squamous cell carcinoma ratio with staging was analyzed by Wilcoxon rank sum test.P<0.05 has a significant statistical difference.Results 219 patients with histologically diagnosed NSCLC who underwent pretreatment ¹⁸F-FDG PET scans were retrospectively analyzed.There were 122 ADC?stage?,?,? were 61,22 and 39?and 97 SCC?stage?,?,? were 25,19 and 53?.SUVs,MTV,TLG and 23 texture parameters?4 global,11 local,8 regional?were positive correlated?rs = 0.14 0.52,all P<0.05?with AJCC stage;22 texture parameters?1 global,12 local,9 regional?were negative correlated?rs =-0.14 ^-0.5,all P<0.05?with AJCC stage.SUVs?eg.SUVmax?,MTV,TLG in SCC were significantly higher than those in ADC?mean±SD:16.51 ± 7.80 vs.9.43 ± 4.76,76.18 ± 87.69 cm3 vs.29.29 ± 43.86cm3,513.55 ± 602.47 g vs.140.89 ± 275.16g;all P<0.05?;5 global,23 local,16 regional texture parameters in SCC were significantly higher than those in ADC,the maximum parameter ratio was up to 3.91 times.SUVs,MTV,TLG in each staging of SCC were significantly higher than ADC.4 global,22 local,10 regional texture parameters in SCC were significantly higher than those in ADC of stage?,the maximum parameter ratio was up to 5.00 times;2 global,10 local,6 regional texture parameters in SCC were significantly higher than those in ADC of stage?,the maximum parameter ratio was up to 4.06 times.4 global,18 local,14 regional texture parameters in SCC were significantly higher than those in ADC of stage ?,the maximum parameter ratio was up to 2.46 times.The metabolic parameters parameter ratio?median 1.48,range 1.13 4.49?of stage ? was significantly lower than those of stage I?2.18,1.13 4.40;P = 0.13?and stage II?1.99,1.24 5.21;P =0.31?;The parameter ratio?1.34,1.03 2.46?of texture parameters of stage ? was significantly lower than that of stage I?1.42,1.04 5.00;P = 0.0001?and stage II?1.60,1.02 4.06;P <0.0001?in the texture parameters was positive correlation with AJCC stage.Conclusion The metabolic and heterogeneity parameters of ¹⁸F-FDG PET in SCC were significantly higher than those in ADC,and the difference between them showed a decreasing trend with the increase of AJCC grade.