Texture analysis of [ 18 F]-fluorodeoxyglucose-positron emission tomography/computed tomography for predicting the treatment response of postoperative recurrent or metastatic oral squamous cell carcinoma treated with cetuximab

Objective To assess the value of the texture analysis of fluorine- 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in predicting the treatment response of postoperative recurrent or metastatic oral squamous cell carcinoma (POR/M-OSCC) treated with cetuximab. Methods A total of 14 patients undergoing 18 F-FDG-PET/CT with POR/M-OSCC were divided into the responder and non-responder groups according to cetuximab response by Response Evaluation Criteria in Solid Tumors (RECIST). The regions of interest (ROI) were set at the POR/M-OSCC lesions with the highest uptake of 18 F-FDG, and the volumetric and texture features were analyzed. The features with correlation coefficient of 0.6 or more were further evaluated using the logistic regression analysis to create a model. Results The SHAPE Volume(vx) , SHAPE Volume(mL) , metabolic tumor volume (MTV), and gray-level run-length matrix run-length nonuniformity (GLRLM RLNU ) were significantly different between the responder ( n = 6) and non-responder ( n = 8) groups ( p = 0.044, 0.042, 0.047, and 0.012, respectively). The model’s area under the curve (AUC) was found to be 0.83, 0.83, 0.79, and 0.92, respectively. The heatmap with PET feature dendrogram showed four distinct clusters including them in patient’s responder and non-responder groups. Conclusions Higher MTV, GLRLM RLNU , SHAPE Volume(vx) , and SHAPE Volume(mL) in 18 F-FDG-PET images may have the prediction values for treatment response with POR/M-OSCC treated with cetuximab.