本研究旨在探讨 PET/CT 放射组学对预测可切除胰腺导管腺癌 (PDAC) 患者总生存期 (OS) 的预后意义。我们纳入了 627 名可切除 PDAC 患者，他们接受了术前 18F-FDG PET/CT 和随后的治疗外科手术。使用 Chang-Gung 图像纹理分析工具箱对原发肿瘤的 PET/CT 图像进行放射组学分析。对放射组学特征进行最小绝对收缩和选择算子 (LASSO) 回归，以选择 OS 最有价值的成像特征。通过Cox比例风险回归分析评估预后意义。通过时间依赖性受试者工作特征曲线分析，将常规 PET 参数和 LASSO 评分作为 OS 的预测因素进行评估。在平均 28.8 个月的随访期间，378 名患者 (60.3%) 死亡。在多变量Cox回归分析中，肿瘤分化、切缘状态、肿瘤分期和LASSO评分是OS的独立预后因素（HR分别为1.753、1.669、2.655和2.946；均P < 0.001）。时间依赖性受试者工作特征曲线分析表明，LASSO评分比传统PET参数对OS具有更好的预测性能。使用原发肿瘤的18F-FDG PET/CT影像组学得出的LASSO评分是预测OS的独立预后因素。患有可切除 PDAC 的患者，可能有助于确定这些患者的治疗和随访计划。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

This study aimed to investigate the prognostic significance of PET/CT radiomics to predict overall survival (OS) in patients with resectable pancreatic ductal adenocarcinoma (PDAC).We enrolled 627 patients with resectable PDAC who underwent preoperative 18F-FDG PET/CT and subsequent curative surgery. Radiomics analysis of the PET/CT images for the primary tumor was performed using the Chang-Gung Image Texture Analysis toolbox. Radiomics features were subjected to least absolute shrinkage and selection operator (LASSO) regression to select the most valuable imaging features of OS. The prognostic significance was evaluated by Cox proportional hazards regression analysis. Conventional PET parameters and LASSO score were assessed as predictive factors for OS by time-dependent receiver operating characteristic curve analysis.During a mean follow-up of 28.8 months, 378 patients (60.3%) died. In the multivariable Cox regression analysis, tumor differentiation, resection margin status, tumor stage, and LASSO score were independent prognostic factors for OS (HR, 1.753, 1.669, 2.655, and 2.946; all P < 0.001, respectively). The time-dependent receiver operating characteristic curve analysis showed that the LASSO score had better predictive performance for OS than conventional PET parameters.The LASSO score using the 18F-FDG PET/CT radiomics of the primary tumor was the independent prognostic factor for predicting OS in patients with resectable PDAC and may be helpful in determining therapeutic and follow-up plans for these patients.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.