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263 Radiomics of the primary tumour as a tool to improve 18F-FDG-PET sensitivity in detecting nodal metastases in women with apparent early endometrial cancer
  1. A Buda1,
  2. C Crivellaro2,
  3. E Bernardi3,
  4. D Giuliani1,
  5. F Elisei4,
  6. M La Manna1,
  7. L Guerra4,
  8. M Delle Marchette1,
  9. T Grassi1,
  10. ML Di Meo1,
  11. M Adorni1,
  12. N Bellante1,
  13. C Landoni2 and
  14. R Fruscio5
  1. 1Unit Gynecology Oncology Surgery- San Gerardo Hospital- Monza, Obstetrics and Gynecology, Monza, Italy
  2. 2University of Milano-Bicocca, Nuclear Medicine, Monza, Italy
  3. 3University of Milano-Bicocca, Medicine and Surgery, Monza, Italy
  4. 4San Gerardo Hospital, Nuclear Medicine, Monza, Italy
  5. 5University of Milano-Bicocca, Obstetrics and Gynecology, Monza, Italy


Objectives In this study we investigated the role of radiomic applied in women with endometrial cancer underwent 18F-FDG PET scan, to evaluate if imaging features computed on the primary tumor could improve sensitivity in detection of lymph node (LN) metastases.

Methods Between 1/2009 and 12/2018, 116 women underwent preoperative 18F-FDG PET/CT were considered. SUV, MTV, TLG, geometrical shape, histograms and texture features were computed inside tumor contours. In group 1 (87 patients), univariate association with LN metastases was computed by Mann-Whitney test and a neural network multivariate model was developed. Univariate and multivariate models were assessed with leave one out on 20 training sessions and on group 2 (29 patients).

Results Sensitivity and specificity of LN visual detection were 50% and 99% on group 1 and 33% and 95% on group 2. The lower sensitivity of visual detection in group 2 is mainly related to the higher rate of micrometastases (25% vs 13%). A unique heterogeneity feature computed on the primary tumor (GLSZM ZP) was able to predict LN metastases better than any other feature, or multivariate model (sensitivity and specificity of 75% and 81% in group 1 and of 89% and 80% in group 2). Tumors with LN metastases generally demonstrated a lower GLSZM ZP value, i.e. by the co-presence of high-uptake and low-uptake areas.

Conclusions In our study the computation of imaging features on the primary tumor increases nodal staging for detection sensitivity in 18F-FDG PET and can be considered for a better planning of the surgical treatment.

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