Visual Versus Quantitative Assessment of Intratumor 18F-FDG PET Uptake Heterogeneity: Prognostic Value in Non-Small Cell Lung Cancer.: FDG PET heterogeneity in NSCLC

Abstract : The goal of this study was to compare visual assessment of intra-tumor 18F-FDG PET uptake distribution with a textural features (TF) automated quantification and to establish their respective prognostic value in non-small cell lung cancer (NSCLC). METHODS: The study retrospectively included 102 consecutive patients. Only primary tumors were considered. Intra-tumor heterogeneity was visually scored (3-level scale (Hvisu)) by two nuclear medicine physicians. Tumor volumes were automatically delineated and heterogeneity was quantified with TF. Mean and maximum SUV were also included. Visual inter-observer agreement and correlations with quantitative assessment were evaluated using the Kappa test and Spearman rank (r) coefficient respectively. Association with overall survival (OS) and recurrence-free survival (RFS) was investigated using the Kaplan-Meier method and Cox regression models. RESULTS: Moderate correlations (0.4