Prognostic Value of Pseudotime from Texture Parameters of [F]fluorodeoxyglucose PET/CT in Resectable Pancreatic Ductal Adenocarcinoma.
[RATIONALE AND OBJECTIVES] This study evaluates the prognostic value of pseudotime derived from radiomics texture parameters on [F]fluorodeoxyglucose positron emission tomography/computed tomography (
- p-value p < 0.001
- p-value p = 0.009
- HR 1.48
APA
Whi W, Hyun SH, et al. (2026). Prognostic Value of Pseudotime from Texture Parameters of [F]fluorodeoxyglucose PET/CT in Resectable Pancreatic Ductal Adenocarcinoma.. Academic radiology, 33(1), 189-200. https://doi.org/10.1016/j.acra.2025.10.016
MLA
Whi W, et al.. "Prognostic Value of Pseudotime from Texture Parameters of [F]fluorodeoxyglucose PET/CT in Resectable Pancreatic Ductal Adenocarcinoma.." Academic radiology, vol. 33, no. 1, 2026, pp. 189-200.
PMID
41152105
Abstract
[RATIONALE AND OBJECTIVES] This study evaluates the prognostic value of pseudotime derived from radiomics texture parameters on [F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) images of resectable pancreatic ductal adenocarcinoma (PDAC) patients.
[MATERIALS AND METHODS] We retrospectively analyzed data from 711 patients who underwent FDG PET/CT before surgery. We extracted 56 radiomics features and calculated the pseudotime, a continuous metric estimating disease progression, using the Phenopath algorithm. Clinicopathologic features and other conventional PET parameters were also obtained. Correlation analyses were performed between the conventional PET parameters and pseudotime, and survival analysis was performed according to the clinicopathologic variables.
[RESULTS] Correlation analysis revealed that pseudotime correlates weakly with SUVmax and SUVmean and strongly with the metabolic tumor volume (MTV) and total lesion glycolysis (TLG). A multivariate survival analysis revealed that pseudotime is an independent predictor of disease-free survival (hazard ratio [HR] = 1.67, p < 0.001, c-index = 0.59), showing stronger prognostic performance than MTV (HR = 1.48, p = 0.009, c = 0.57) and TLG (HR = 1.39, p = 0.03, c = 0.56). When pseudotime was combined with TLG for risk stratification, the integrated model demonstrated the strongest prognostic separation among subgroups. Texture parameters related to homogeneity correlated positively with pseudotime, and those representing heterogeneity showed mixed correlations, highlighting the complexity of tumor biology.
[CONCLUSION] Our findings indicate that pseudotime is a meaningful prognostic biomarker in resectable PDAC patients undergoing surgery, with stronger predictive power than established metabolic parameters. Stratification performance improved when it was combined with conventional markers.
[MATERIALS AND METHODS] We retrospectively analyzed data from 711 patients who underwent FDG PET/CT before surgery. We extracted 56 radiomics features and calculated the pseudotime, a continuous metric estimating disease progression, using the Phenopath algorithm. Clinicopathologic features and other conventional PET parameters were also obtained. Correlation analyses were performed between the conventional PET parameters and pseudotime, and survival analysis was performed according to the clinicopathologic variables.
[RESULTS] Correlation analysis revealed that pseudotime correlates weakly with SUVmax and SUVmean and strongly with the metabolic tumor volume (MTV) and total lesion glycolysis (TLG). A multivariate survival analysis revealed that pseudotime is an independent predictor of disease-free survival (hazard ratio [HR] = 1.67, p < 0.001, c-index = 0.59), showing stronger prognostic performance than MTV (HR = 1.48, p = 0.009, c = 0.57) and TLG (HR = 1.39, p = 0.03, c = 0.56). When pseudotime was combined with TLG for risk stratification, the integrated model demonstrated the strongest prognostic separation among subgroups. Texture parameters related to homogeneity correlated positively with pseudotime, and those representing heterogeneity showed mixed correlations, highlighting the complexity of tumor biology.
[CONCLUSION] Our findings indicate that pseudotime is a meaningful prognostic biomarker in resectable PDAC patients undergoing surgery, with stronger predictive power than established metabolic parameters. Stratification performance improved when it was combined with conventional markers.
MeSH Terms
Humans; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Female; Male; Carcinoma, Pancreatic Ductal; Pancreatic Neoplasms; Prognosis; Retrospective Studies; Middle Aged; Radiopharmaceuticals; Aged; Aged, 80 and over; Adult