According the results of a study published in Contrast Media & Molecular Imaging, radiomic features of baseline 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) appear to be independent prognostic factors for survival outcomes in Hodgkin lymphoma (HL).

To investigate whether the radiomic features of baseline 18F-FDG PET can predict the prognosis of HL, the investigators retrospectively enrolled 65 patients with HL (69% male and 31% female; mean age, 29 years; range, 8-72) to a single-center study. The patients were randomly divided (7:3) into training (n=49) and validation cohorts (n=16).

The researchers extracted 47 radiomic features from pretreatment PET images and used the least absolute shrinkage and selection operator regression to select the most useful prognostic features in the training cohort. They also recorded the distance between the two lesions that were the furthest apart (Dmax) and assessed the prognostic models with the receiver operating characteristic curve, Kaplan-Meier method, and Cox proportional-hazards model.

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The investigators identified 2 factors that were independently correlated with 2-year progression-free survival (PFS), long-zone high gray-level emphasis extracted from a gray-level zone-length matrix (LZHGEGLZLM; hazard ratio [HR] =9.007; P =.044) and Dmax (HR =3.641; P =.048). Using these 2 prognostic factors, they built a prognostic stratification model that was capable of distinguishing 3 risk groups for PFS (P =.0002), with 2-year PFS of 100.0%, 64.7%, and 33.3%. The investigators proposed that this prognostic stratification model could further improve the risk stratification of patients with HL.

Limitations of the study included the single-center, retrospective design, potential selection bias, the relatively small sample size of the training cohort, and potential interobserver variability across image readers. The researchers suggest that a large-scale multicenter study of the risk model is needed for further validation.

“Our results indicated the association between pretreatment 18F-FDG PET radiomic features and relapsed disease status in HL patients. Besides, a prognostic scoring system consisting of the Dmax and LZHGEGLZLM could be useful to improve risk stratification, which might be beneficial for personalized treatment,” the authors concluded.


Zhou Y, Zhu Y, Chen Z, Li J, Sang S, Deng S. Radiomic features of 18F-FDG PET in Hodgkin lymphoma are predictive of outcomes. Contrast Media Mol Imaging. 2021;2021:6347404. doi:10.1155/2021/6347404