{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T17:43:01Z","timestamp":1771263781364,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The purpose of this study was to determine whether texture analysis features present on pretreatment unenhanced computed tomography (CT) images, derived from 18F-fluorodeoxyglucose positron emission\/computed tomography (18-FDG PET\/CT), can predict progression-free survival (PFS), progression-free survival at 24 months (PFS 24), time to next treatment (TTNT), and overall survival in patients with high-tumor-burden follicular lymphoma treated with immunochemotherapy and rituximab maintenance. Seventy-two patients with follicular lymphoma were retrospectively included. Texture analysis was performed on unenhanced CT images extracted from 18-FDG PET\/CT examinations that were obtained within one month before treatment. Skewness at a fine texture scale (SSF = 2) was an independent predictor of PFS (hazard ratio = 3.72 (95% CI: 1.15, 12.11), p = 0.028), PFS 24 (hazard ratio = 13.38; 95% CI: 1.29, 138.13; p = 0.029), and TTNT (hazard ratio = 5.11; 95% CI: 1.18, 22.13; p = 0.029). Skewness values above \u22120.015 at SSF = 2 were significantly associated with lower PFS, PFS 24, and TTNT. Kurtosis without filtration was an independent predictor of PFS (SSF = 0; HR = 1.22 (95% CI: 1.04, 1.44), p = 0.013), and TTNT (SSF = 0; hazard ratio = 1.23; 95% CI: 1.04, 1.46; p = 0.013). This study shows that pretreatment unenhanced CT texture analysis-derived tumor skewness and kurtosis may be used as predictive biomarkers of PFS and TTNT in patients with high-tumor-burden follicular lymphoma treated with immunochemotherapy and rituximab maintenance.<\/jats:p>","DOI":"10.3390\/diagnostics13132237","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T16:08:32Z","timestamp":1688141312000},"page":"2237","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pretreatment CT Texture Parameters as Predictive Biomarkers of Progression-Free Survival in Follicular Lymphoma Treated with Immunochemotherapy and Rituximab Maintenance"],"prefix":"10.3390","volume":"13","author":[{"given":"Carole","family":"Durot","sequence":"first","affiliation":[{"name":"Department of Radiology, Reims University Hospital, 45 Rue Cognacq-Jay, 51092 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3463-0089","authenticated-orcid":false,"given":"Eric","family":"Durot","sequence":"additional","affiliation":[{"name":"Department of Hematology, Reims University Hospital, 45 Rue Cognacq-Jay, 51092 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6896-6149","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Mul\u00e9","sequence":"additional","affiliation":[{"name":"Department of Radiology, Henri Mondor University Hospital, 51 Avenue du Mar\u00e9chal de Lattre de Tassigny, 94010 Cr\u00e9teil, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris-Est Cr\u00e9teil, 61 Avenue du G\u00e9n\u00e9ral de Gaulle, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8738-4841","authenticated-orcid":false,"given":"David","family":"Morland","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Godinot Institute, 1 Rue du G\u00e9n\u00e9ral Koenig, 51100 Reims, France"},{"name":"CReSTIC, EA 3804, University of Reims Champagne-Ardenne, UFR Moulin de la Housse, 51867 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Godard","sequence":"additional","affiliation":[{"name":"Department of Radiology, Henri Mondor University Hospital, 51 Avenue du Mar\u00e9chal de Lattre de Tassigny, 94010 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Quinquenel","sequence":"additional","affiliation":[{"name":"Department of Hematology, Reims University Hospital, 45 Rue Cognacq-Jay, 51092 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1430-2574","authenticated-orcid":false,"given":"Alain","family":"Delmer","sequence":"additional","affiliation":[{"name":"Department of Hematology, Reims University Hospital, 45 Rue Cognacq-Jay, 51092 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-1682","authenticated-orcid":false,"given":"Philippe","family":"Soyer","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4pital Cochin, AP-HP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Paris Cit\u00e9, 75006 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Hoeffel","sequence":"additional","affiliation":[{"name":"Department of Radiology, Reims University Hospital, 45 Rue Cognacq-Jay, 51092 Reims, France"},{"name":"CReSTIC, EA 3804, University of Reims Champagne-Ardenne, UFR Moulin de la Housse, 51867 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3322\/caac.21357","article-title":"US lymphoid malignancy statistics by World Health Organization subtypes","volume":"66","author":"Teras","year":"2016","journal-title":"CA Cancer J. 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