{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T21:33:19Z","timestamp":1787866399784,"version":"build-2784847793"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["GR-2019-12370372"],"award-info":[{"award-number":["GR-2019-12370372"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Patients with low tumour burden follicular lymphoma (FL) are managed with an initial watchful waiting (WW) approach. The way to better predict the time-to-treatment (TTT) is still under investigation for its possible clinical impact. This study explored whether radiomic features extracted from baseline 18F-FDG PET\/CT could predict TTT in FL patients on WW. Methods: Thirty-eight patients on initial WW (grade 1\u20133a) were retrospectively included from 2010 to 2019. Eighty-one PET\/CT morphological and first-level intensity radiomic features were extracted from the total metabolic tumour burden (TMTV), the lesion having the highest SUVmax and a reference volume-of-interest placed on the healthy liver. Models using linear regression (LR) and support vector machine (SVM) were constructed to assess the feasibility of using radiomic features to predict TTT. A leave-one-out cross-validation approach was used to assess the performance. Results: For LR models, we found a root-mean-squared error of 29.4, 28.6, 26.4 and 26.8 and an R2 of 0.03, 0.08, 0.21 and 0.20, respectively, incrementing the features from one to four. Accordingly, the best model included three features: the liver minimum SUV value, the liver SUV skewness and the sum of squared SUV values in the TMTV. For SVM models, accuracies of 0.79, 0.63, 0.76 and 0.68 and areas under the curve of 0.80, 0.72, 0.77 and 0.63 were found, respectively, incrementing the features from one to four. The best performing model used one feature, namely the median value of the lesion containing the SUVmax value. Conclusions: The baseline PET\/CT radiomic approach has the potential to predict TTT in FL patients on WW. Integrating radiomics with clinical parameters could further aid in patient stratification.<\/jats:p>","DOI":"10.3390\/diagnostics15040432","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T11:01:08Z","timestamp":1739271668000},"page":"432","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Predictive Role of Baseline 18F-FDG PET\/CT Radiomics in Follicular Lymphoma on Watchful Waiting: A Preliminary Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2432-5024","authenticated-orcid":false,"given":"Daria","family":"Maccora","sequence":"first","affiliation":[{"name":"Nuclear Medicine Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy"},{"name":"Section of Nuclear Medicine, Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, L.go A. Gemelli, 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Guerreri","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Malafronte","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"D\u2019Al\u00f2","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Section of Haematology, Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-7197","authenticated-orcid":false,"given":"Stefan","family":"Hohaus","sequence":"additional","affiliation":[{"name":"Hematology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Section of Haematology, Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5951-0177","authenticated-orcid":false,"given":"Marco","family":"De Summa","sequence":"additional","affiliation":[{"name":"Medipass S.p.a. Integrative Service, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1045-0633","authenticated-orcid":false,"given":"Vittoria","family":"Rufini","sequence":"additional","affiliation":[{"name":"Section of Nuclear Medicine, Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, L.go A. Gemelli, 8, 00168 Rome, Italy"},{"name":"Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli, 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4716-9925","authenticated-orcid":false,"given":"Roberto","family":"Gatta","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5631-1575","authenticated-orcid":false,"given":"Luca","family":"Boldrini","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6000-2898","authenticated-orcid":false,"given":"Lucia","family":"Leccisotti","sequence":"additional","affiliation":[{"name":"Section of Nuclear Medicine, Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, L.go A. Gemelli, 8, 00168 Rome, Italy"},{"name":"Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli, 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli, 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1111\/bjh.16489","article-title":"Trends in the prevalence, incidence and survival of non-Hodgkin lymphoma subtypes during the 21st century\u2014A Swedish lymphoma register study","volume":"189","author":"Ekberg","year":"2020","journal-title":"Br. J. Haematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1002\/ajh.24200","article-title":"Follicular lymphoma: 2015 update on diagnosis and management","volume":"90","author":"Freedman","year":"2015","journal-title":"Am. J. 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