Peritumoral FDG-PET radiomics predicts tumor spread through air spaces in non-small-cell lung cancer

In 104 patients, fluorodeoxyglucose PET radiomics using a 5-mm peritumoral region predicted tumor spread through air spaces with AUC 0.79, outperforming tumor-only (0.70) and 10-mm peritumoral (0.74) models; SUVmax, SUVmean, and SUVpeak did not differ.

• Retrospective study of 104 patients with non-small-cell lung cancer classified by postoperative histopathology; 60 were STAS-positive.
• The 5-mm peritumoral radiomics model yielded the highest AUC (0.79) with logistic regression; tumor-only and 10-mm peritumoral models had AUCs of 0.70 and 0.74.
• Tumor size, total lesion glycolysis, and metabolic tumor volume were higher in STAS-positive cases, while SUVmax, SUVmean, and SUVpeak did not differ.

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