Abstract:
Radiomics or textural feature extraction obtained from positron emission tomography
(PET) images through complex mathematical models of the spatial relationship between multiple
image voxels is currently emerging as a new tool for assessing intra-tumoral heterogeneity in medical
imaging. In this paper, available literature on texture analysis using FDG PET imaging in patients
suffering from tumors of the gastro-intestinal tract is reviewed. While texture analysis of FDG PET
images appears clinically promising, due to the lack of technical specifications, a large variability in
the implemented methodology used for texture analysis and lack of statistical robustness, at present,
no firm conclusions can be drawn regarding the predictive or prognostic value of FDG PET texture
analysis derived indices in patients suffering from gastro-enterologic tumors. In order to move
forward in this field, a harmonized image acquisition and processing protocol as well as a harmonized
protocol for texture analysis of tumor volumes, allowing multi-center studies excluding statistical
biases should be considered. Furthermore, the complementary and additional value of CT-imaging,
as part of the PET/CT imaging technique, warrants exploration.
