Development of a 18F-FDG PET/CT-based radiomic risk score as an independent prognostic factor in small cell lung cancer
Annals of Nuclear Medicine, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s12149-026-02261-6
- Dergi Adı: Annals of Nuclear Medicine
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, CINAHL, EMBASE, MEDLINE, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest), Technology Collection (ProQuest)
- Anahtar Kelimeler: 18F-FDG PET/CT, Decision curve analysis, LASSO, Rad-score, Small cell lung cancer, Survival
- Sivas Cumhuriyet Üniversitesi Adresli: Evet
Özet
Objective: Prognosis in small cell lung cancer (SCLC) remains poorly predicted by conventional staging and metabolic parameters. This study aimed to develop a positron emission tomography/computed tomography (PET/CT) based Radiomic Risk Score (Rad-Score), evaluate its independent prognostic value for overall survival (OS), and assess the clinical utility of an integrated model using Decision Curve Analysis (DCA). Materials and methods: 143 SCLC patients (120 male, 23 female) who underwent pre-treatment staging 18F-fluorodeoxyglucose (18F-FDG) PET/CT between January 2012 and June 2024 were included. Using LIFEx (v25.06.1), 129 Image Biomarker Standardisation Initiative (IBSI) compliant radiomic features were extracted alongside standard metabolic parameters (SUVmax, SUVmean, MTV, TLG). After eliminating highly correlated features (|r|> 0.90), five key features were selected via tenfold cross-validation LASSO-Cox regression to construct the Rad-Score. Patients were stratified into Low and High Radiomic Risk groups. Independent prognostic factors were identified through Cox regression analyses, and the incremental value of the Rad-Score was assessed by hierarchical C-index comparisons and DCA. Results: Median OS was 10.8 months (95% CI: 8.2–13.3), with a mortality rate of 83.9%. Multivariable analysis identified the Radiomic Risk Group (HR: 2.12; 95% CI: 1.33–3.40; p = 0.002) and Curative CRT (HR: 0.17; 95% CI: 0.06–0.48; p < 0.001) as independent prognostic factors. The C-index improved from 0.657 to 0.688 (p = 0.018) and to 0.701 with Rad-Score integration (p = 0.0017). DCA demonstrated superior net benefit at high threshold probabilities (≥ 65%). Conclusion: The 18F-FDG PET/CT-based Rad-Score independently predicts survival in SCLC beyond conventional staging and metabolic parameters. The integrated model provides meaningful incremental prognostic value; however, multicenter external validation is warranted prior to clinical implementation.