Quantitative Radiomics Features in Diffuse Large B-Cell Lymphoma: Does Segmentation Method Matter?

Jakoba J Eertink, Elisabeth A G Pfaehler, Sanne E Wiegers, Tim van de Brug, Pieternella J Lugtenburg, Otto S Hoekstra, Josee M Zijlstra, Henrica C W de Vet, Ronald Boellaard

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15 Citations (Scopus)


Radiomics features may predict outcome in diffuse large B-cell lymphoma (DLBCL). Currently, multiple segmentation methods are used to calculate metabolic tumor volume (MTV). We assessed the influence of segmentation method on the discriminative power of radiomics features in DLBCL at the patient level and for the largest lesion. Methods: Fifty baseline 18F-FDG PET/CT scans of DLBCL patients with progression or relapse within 2 years after diagnosis were matched on uptake time and reconstruction method with 50 baseline PET/CT scans of DLBCL patients without progression. Scans were analyzed using 6 semiautomatic segmentation methods (SUV threshold of 4.0 [SUV4.0], SUV threshold of 2.5, 41% of SUVmax, 50% of SUVpeak, a majority vote segmenting voxels detected by $2methods, and a majority vote segmenting voxels detected by $3 methods). On the basis of these segmentations, 490 radiomics features were extracted at the patient level, and 486 features were extracted for the largest lesion. To quantify the agreement between features extracted from different segmentation methods, the intraclass correlation (ICC) agreement was calculated for each method compared with SUV4.0. The feature space was reduced by deleting features that had high Pearson correlations ($0.7) with the previously established predictors MTV or SUVpeak. Model performance was assessed using stratified repeated cross validation with 5 folds and 2,000 repeats, yielding the mean receiver-operating-characteristics curve integral for all segmentation methods using logistic regression with backward feature selection. Results: The percentage of features yielding an ICC of at least 0.75, compared with the SUV4.0 segmentation, was lowest for 50% of SUVpeak both at the patient level and for the largest lesion, with 77.3% and 66.7% of the features yielding an ICC of at least 0.75, respectively. Features did not correlate strongly with MTV, with at least 435 features at the patient level and 409 features for the largest lesion for all segmentation methods having a correlation coefficient of less than 0.7. Features correlated strongly with SUVpeak (at least 190 at patient level and 134 for the largest lesion were uncorrelated to SUVpeak, respectively). Receiver-operatingcharacteristics curve integrals ranged between 0.6960.11 and 0.8460.09 at the patient level and between 0.6960.11 and 0.7360.10 at the lesion level. Conclusion: Even though there are differences in the actual radiomics feature values derived and selected features among segmentation methods, there is no substantial difference in the discriminative power of radiomics features among segmentation methods.

Original languageEnglish
Pages (from-to)389-395
Number of pages7
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine
Issue number3
Early online date16 Jul 2021
Publication statusPublished - 1 Mar 2022


  • 18F-FDG PET/CT
  • diffuse large B-cell lymphoma
  • radiomics
  • segmentation methods

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