Int J Med Sci 2021; 18(16):3624-3630. doi:10.7150/ijms.64458

Research Paper

Radiomics based on fluoro-deoxyglucose positron emission tomography predicts liver fibrosis in biopsy-proven MAFLD: a pilot study

Zhong-Wei Chen1, Kun Tang2, You-Fan Zhao1, Yang-Zong Chen2, Liang-Jie Tang3, Gang Li3, Ou-Yang Huang3, Xiao-Dong Wang4, Giovanni Targher5, Christopher D. Byrne6, Xiang-Wu Zheng1,2✉, Ming-Hua Zheng3,4,7✉

1. Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
2. Department of Nuclear Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
3. NAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
4. Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China.
5. Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
6. Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK.
7. Institute of Hepatology, Wenzhou Medical University, Wenzhou, China.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
Citation:
Chen ZW, Tang K, Zhao YF, Chen YZ, Tang LJ, Li G, Huang OY, Wang XD, Targher G, Byrne CD, Zheng XW, Zheng MH. Radiomics based on fluoro-deoxyglucose positron emission tomography predicts liver fibrosis in biopsy-proven MAFLD: a pilot study. Int J Med Sci 2021; 18(16):3624-3630. doi:10.7150/ijms.64458. Available from https://www.medsci.org/v18p3624.htm

File import instruction

Abstract

Graphic abstract

Rationale: Since non-invasive tests for prediction of liver fibrosis have a poor diagnostic performance for detecting low levels of fibrosis, it is important to explore the diagnostic capabilities of other non-invasive tests to diagnose low levels of fibrosis. We aimed to evaluate the performance of radiomics based on 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in predicting any liver fibrosis in individuals with biopsy-proven metabolic dysfunction-associated fatty liver disease (MAFLD).

Methods: A total of 22 adults with biopsy-confirmed MAFLD, who underwent 18F-FDG PET/CT, were enrolled in this study. Sixty radiomics features were extracted from whole liver region of interest in 18F-FDG PET images. Subsequently, the minimum redundancy maximum relevance (mRMR) method was performed and a subset of two features mostly related to the output classes and low redundancy between them were selected according to an event per variable of 5. Logistic regression, Support Vector Machine, Naive Bayes, 5-Nearest Neighbor and linear discriminant analysis models were built based on selected features. The predictive performances were assessed by the receiver operator characteristic (ROC) curve analysis.

Results: The mean (SD) age of the subjects was 38.5 (10.4) years and 17 subjects were men. 12 subjects had histological evidence of any liver fibrosis. The coarseness of neighborhood grey-level difference matrix (NGLDM) and long-run emphasis (LRE) of grey-level run length matrix (GLRLM) were selected to predict fibrosis. The logistic regression model performed best with an AUROC of 0.817 [95% confidence intervals, 0.595-0.947] for prediction of liver fibrosis.

Conclusion: These preliminary data suggest that 18F-FDG PET radiomics may have clinical utility in assessing early liver fibrosis in MAFLD.

Keywords: Metabolic dysfunction-associated fatty liver disease, Fibrosis, Radiomics, 18F-FDG PET/CT