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A proof of concept study of <sup>18</sup>F-FDG PET/CT patient-level radiomics identify refractory/relapsed diffuse large B-cell lymphoma.

September 30, 2025pubmed logopapers

Authors

Cui C,Cao J,Li Y,Jia B,Ma N,Li X,Liang M,Hou M,Zhang Y,Wang H,Wu Z

Affiliations (5)

  • Special Medical Research Institute of Shanxi Medical University, Taiyuan, China.
  • Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.
  • Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Shanxi Medical University, Taiyuan, China.
  • Special Medical Research Institute of Shanxi Medical University, Taiyuan, China. [email protected].
  • Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, China. [email protected].

Abstract

This study aimed to evaluate diffuse large B-cell lymphoma (DLBCL) patients who have refractory/relapsed disease and characterize the heterogeneity of DLBCL using patient-level radiomics analysis based on <sup>18</sup>F-FDG PET/CT. A total of 132 patients diagnosed with DLBCL who underwent <sup>18</sup>F-FDG PET/CT before receiving treatment were selected for the final study. Patient-level volumes of interests (VOI) were extracted from PET/CT images, and 328 radiomics features were extracted subsequently. 8 radiomics features were selected using the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to calculate the radiomics score (rad-score). Additionally, a total of 64 potential ML classifiers were generated based on 8 distinct supervised learning algorithms. The combined model that integrates rad-scores, clinical features and standard PET parameters demonstrates excellent performance; Specifically, ML models based on Naive Bayes have the greatest predicted values (AUC = 0.73). The patient-level radiomics features were subjected to unsupervised non-negative matrix factorization (NMF) clustering analysis to identify 3 radiomics subtypes. Cluster 1 exhibited a substantially higher prevalence of refractory/relapsed DLBCL compared to Clusters 2 and 3 (P < 0.05). Moreover, Cluster 1 showed a significantly higher frequency of advanced Ann Arbor stage, high international prognostic index, and bulk disease (all P < 0.05). In conclusion, Radiomics scores and radiomics subtypes derived from patient-level data offer significant predictive value and phenotypic information for patients with refractory/relapsed DLBCL.

Topics

Lymphoma, Large B-Cell, DiffusePositron Emission Tomography Computed TomographyFluorodeoxyglucose F18Journal Article

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