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Radiomics and Machine Learning in Medical Imaging / Lung Cancer Diagnosis and Treatment · Journal article
Diagnostics · September 10, 2026
Early or partial results. Treat as a signal, not a conclusion.
This retrospective imaging study of 53 lung cancer patients used paired 18F-FDG PET/CT to examine whether longitudinal body composition changes predicted progression-free survival during systemic therapy. Higher delta torso fat volume showed an adjusted association with lower progression risk (HR 0.64) in exploratory full-cohort analysis, but this finding was not confirmed in a temporally aligned validation subgroup, and the authors explicitly state that prognostic relevance requires further validation.
Retrospective cohort study. Patients with confirmed lung cancer undergoing systemic therapy who had paired baseline and post-treatment 18F-FDG PET/CT imaging.. Intervention: Longitudinal 18F-FDG PET/CT imaging during systemic therapy (post-treatment scan) with quantification of body composition and metabolic parameters.. Compared with: Baseline 18F-FDG PET/CT imaging (pre-treatment); delta (change) values compared between progressors and non-progressors.. n = 53.
Skeletal muscle volume decreased post-treatment (p=0.001 after FDR adjustment) Mediastinal fat volume increased post-treatment (p<0.001 after FDR adjustment) Higher delta torso fat volume associated with lower progression risk in full cohort: HR=0.64 (95% CI 0.43–0.97, p=0.033) after adjustment
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While delta torso fat volume showed an adjusted association with reduced progression risk in the full cohort, this finding was not confirmed in the temporally aligned validation subset and carries high exploratory risk. Clinicians should not yet incorporate these body composition measures into prognostic assessment pending prospective validation.
Retrospective single-centre imaging cohort with exploratory endpoints and modest sample size; key finding (delta torso fat volume) failed validation in temporally aligned subgroup analysis and authors acknowledge need for further validation.
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Quoted from the source exactly as published.
While delta torso fat volume showed an adjusted association with reduced progression risk in the full cohort, this finding was not confirmed in the temporally aligned validation subset and carries high exploratory risk. Clinicians should not yet incorporate these body composition measures into prognostic assessment pending prospective validation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Purpose: Host metabolic status may affect outcomes in lung cancer, but longitudinal changes in body composition and systemic metabolism remain incompletely understood. We examined whether paired 18F-FDG PET/CT-derived host features were associated with progression-free survival (PFS) during systemic therapy. Methods: Fifty-three patients with confirmed lung cancer who underwent baseline and post-treatment 18F-FDG PET/CT were retrospectively included. Tumor metabolic burden, body composition, organ metabolism, and brain metabolism were quantified. Delta values were defined as post-treatment minus baseline measurements. Associations with PFS were assessed using Kaplan–Meier analysis, adjusted Cox regression and exploratory metabolic network analysis. Results: During follow-up, 31 patients experienced disease progression, and median PFS was 7 months. SM volume (p = 0.001) decreased, and MedF volume (p < 0.001) increased at follow-up after FDR adjustment, whereas the numerical increases in SAT and TF volumes did not remain statistically significant after correction for multiple comparisons. Higher delta torso fat (TF) volume was associated with a lower risk of progression after adjustment (HR = 0.64, 95% CI: 0.43–0.97, p = 0.033). In the temporally aligned analysis of 29 patients whose follow-up PET/CT preceded progression, delta TF volume was not associated with subsequent PFS (HR, 1.84; 95% CI, 0.91–3.68; p = 0.087). Total network perturbation strength decreased after treatment (p = 0.002) but was not associated with PFS. Conclusions: Paired 18F-FDG PET/CT characterized longitudinal changes in body composition during systemic therapy. Delta TF volume showed an adjusted association with PFS in the exploratory full-cohort model, but its prognostic relevance requires further validation.
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