Predictive value of 18F-FDG PET conventional parameters and radiomics features for invasive breast cancer patients with uncertain HER2 expression by immunohistochemistry

中华核医学与分子影像杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2019.11.001

Yufan Zhang, Jianjing Liu, Xiaofeng Li

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Abstract

Objective To explore the predictive value of 18F-fluorodeoxyglucose (FDG) PET conventional parameters and radiomics features for human epidermal growth factor receptor 2 (HER2) expression which was uncertain by immunohistochemistry (IHC) detection in invasive breast cancer. Methods From April 2012 to December 2017, 76 patients (all were females, age: (50.8±10.9) years) with invasive breast cancer and with uncertain HER2 expression by IHC in Tianjin Medical University Cancer Institute and Hospital were enrolled retrospectively. The 18F-FDG PET/CT images before treatment were reviewed and the expression of HER2 were confirmed by fluorescence in situ hybridization (FISH). The tumor lesions were manually outlined, and the radiomics features from PET images were extracted. Wilcoxon test was used to determine whether there was difference in PET conventional metabolic parameters (maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG)) and radiomics features between HER2-negative and HER2-positive groups. The receiver operating characteristic (ROC) curve analysis was used to compare the predictive efficacy of PET radiomics features for HER2 expression. Results There were 41 HER2-positive patients and 35 HER2-negative patients. No significant differences in PET conventional metabolic parameters between different HER2 expression groups were observed (U values: from -1.598 to 1.551, all P>0.05). A total of 38 PET radiomics features were extracted, and there were significant differences in gray mean, correlation, contrast, inertia, and inverse different moments between 2 groups(U values: from -2.413 to 2.527, all P<0.05). The area under the curve of the above 5 parameters for prediction of HER2 expression were 0.643, 0.638, 0.647, 0.644 and 0.643, respectively, and the contrast was the best parameter. Conclusions PET radiomics features can effectively identify HER2 expression in patients with invasive breast cancer to some extent, and the contrast may be the best. Conventional metabolic parameters have limited predictive value. Key words: Breast neoplasms; Receptor, epidermal growth factor; Immunohistochemistry; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Radiomics

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18F-FDG PET常规参数和放射组学特征对HER2表达不确定的侵袭性癌症患者的免疫组化预测价值

目的探讨18F-氟脱氧葡萄糖（FDG）PET常规参数和放射组学特征对免疫组织化学（IHC）检测不确定的人表皮生长因子受体2（HER2）在侵袭性癌症中表达的预测价值。方法回顾性分析天津医科大学癌症研究所和医院2012年4月至2017年12月收治的76例（均为女性，年龄：（50.8±10.9）岁）经IHC检测HER2表达不确定的侵袭性乳腺癌症患者。回顾治疗前的18F-FDG PET/CT图像，并通过荧光原位杂交（FISH）证实HER2的表达。手动勾勒肿瘤病变，并从PET图像中提取放射组学特征。Wilcoxon检验用于确定HER2阴性组和HER2阳性组之间PET常规代谢参数（最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总损伤糖酵解（TLG））和放射组学特征是否存在差异。受试者工作特性（ROC）曲线分析用于比较PET放射组学特征对HER2表达的预测功效。结果HER2阳性41例，阴性35例。不同HER2表达组之间的PET常规代谢参数没有显著差异（U值：从-1.598到1.551，均P>0.05）。共提取了38个PET放射组学特征，在灰度平均值、相关性、对比度、惯性、，两组之间的差异矩呈反比（U值：从-2.413到2.527，均P<0.05）。上述5个预测HER2表达的参数的曲线下面积分别为0.643、0.638、0.647、0.644和0.643，对比度是最佳参数。结论PET放射组学特征能在一定程度上有效识别侵袭性癌症患者HER2的表达，其对比度最好。传统的代谢参数具有有限的预测价值。关键词：乳腺肿瘤；受体，表皮生长因子；免疫组织化学；正电子发射断层扫描；层析成像，X射线计算机；脱氧葡萄糖；放射组学

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.