Computer-aided staging of lymphoma patients with FDG PET/CT imaging based on textural information

We have designed a computer-aided diagnosis system to discriminate between hypermetabolic cancer lesions and hypermetabolic inflammatory or physiological but noncancerous processes in FDG PET/CT exams of lymphoma patients. Detection performance of the support vector machine (SVM) classifier was assessed based on feature sets including 105 positron emission tomography (PET) and Computed tomography (CT) characteristics derived from the clinical practice and from more sophisticated texture analysis. An original feature selection method based on combining different filter methods was proposed. The evaluation database consisted of 156 lymphomatous and 32 suspicious but nonlymphomatous regions of interest. Different types of training databases including either the PET and CT features or the PET features only, with or without feature selection, were evaluated to assess the added value of multimodality and texture information on classification performance. An optimization study was conducted for each classifier separately to select the best combination of parameters. Promising classification performance was achieved by the SVM classifier combined with the 12 most discriminant PET and CT features with a value of the area under the receiver operating curve of 0.91.