Radiomics based on 2-[¹⁸F]FDG PET/CT can differentiate nonmetastatic gallbladder cancer and cholecystitis

The aim is to develop and validate radiomics based on 2-[¹⁸F]fluoro-D-glucose positron emission tomography (2-[¹⁸F]FDG PET/CT) parameters for differentiating between non-metastatic gallbladder cancer (GBC) and cholecystitis.

A total of 108 patients with non-metastatic GBC and 33 patients with cholecystitis, who underwent 2-[¹⁸F]FDG PET/CT scans between January 2012 and June 2023, were included in our study. The patients were allocated into a training group and a testing group in a ratio of 7:3. The radiomics features extracted from 2-^[18F]FDG PET/CT were subjected to analysis, with the utilization of the mRMR and LASSO regression algorithm for data dimension reduction. The clinical, radiomics and combined models were constructed. The receiver operating characteristic (ROC) curve and decision curve were plotted to assess the differentiating performance.

The area under curve (AUC) of the clinical model and radiomics model was 0.754 (sensitivity = 0.513, specificity = 0.917) and 0.940 (sensitivity = 0.882, specificity = 0.875) in the training group, respectively; 0.691 (sensitivity = 0.938, specificity = 0.333) and 0.906 (sensitivity = 0.781, specificity = 1.000) in the testing group, respectively. In combined models, the AUC was 0.938, the sensitivity was 0.908 and the specificity was 0.958 in the training group; the AUC was 0.964, the sensitivity was 0.781 and the specificity was 1.000 in the training group. The clinical efficacy of the combined model was confirmed by DCA. A nomogram based on the rad-score and clinical variables was developed.

Radiomics based on 2-[¹⁸F]FDG PET/CT can be helpful to differentiate non-metastatic GBC and cholecystitis.