Usefulness of Texture Analysis in ¹¹C-Choline PET/CT for Patients With Prostate Cancer

Texture analysis provides quantitative evaluation of intratumoral heterogeneity of radiopharmaceutical uptake. ComBat harmonization, which reduces batch effects, has been applied in several ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) texture analysis studies. In addition, ¹¹C-Choline PET/CT has been reported to be useful for evaluating urological tumors, including prostate cancer. This study investigated whether texture parameters derived from ¹¹C-Choline PET/CT are associated with prostate cancer aggressiveness.

A retrospective analysis was performed in 18 patients diagnosed with prostate cancer who underwent ¹¹C-Choline PET/CT examinations. Six texture features were evaluated: entropy, homogeneity, dissimilarity, intensity variability (IV), size-zone variability (SZV) and zone percentage (ZP). Correlation coefficients between the six texture parameters and Gleason score were calculated.

Among the evaluated texture parameters, SZV showed the strongest correlation with Gleason score (ρ=0.45), followed by IV (ρ=0.44), entropy (ρ=0.08), homogeneity (ρ=0.04), ZP (ρ=0.03), and dissimilarity (ρ=-0.02).

SZV and IV derived from ¹¹C-Choline PET/CT showed correlations with Gleason score and warrant further investigation as potential imaging biomarkers of prostate cancer aggressiveness.