Analysis of intratumor heterogeneity robustness derived from FDG-PET in mantle cell lymphoma patients enrolled in the Lyma trial

Objective. - The use of texture analysis of PET images has known a significant growth in recent years. The objective of this study was to identify the most robust and relevant textural features indices for patients with mantle cell lymphoma (MCL), in which the use of the SUV remains controversial. Materials and methods. - Patients enrolled in this study were derived from an ancillary study of the multicenter phase III LyMa trial. The most intense focus was extracted for each patient using three delineations methods: Fuzzy Locally Adaptative Bayesian approach, 40% of the SUV_max and a threshold of 2.5 of SUV. Fifteen different textural features have been calculated for each lesion for a total of 45 measurements. Results. - FDG-PET data of 92 patients from 28 different centers were included. Five textural feature parameters were very significantly dependent on the segmentation method. All textural features exhibited high inter-correlation and the most inter-correlated parameters were grouped according to their correlation index allowing us to identify four groups. Correlations between SUV and textural features were low. Eight parameters were highly correlated to volume and three of these became independent above a specific volume. Five parameters were found to be independent of the volume of interest in which they were calculated. Conclusion. - Only a few textural features may bring complimentary and non-redundant quantitative information regarding existing indices. (authors)