旨在研究基于呼吸门控 (RG) PET/CT 的放射组学特征与非门控 (UG) PET/CT 相比在区分非小细胞肺癌 (NSCLC) 和良性病变方面的变异性和诊断功效。 117 名疑似患者前瞻性纳入 2020 年 3 月至 2021 年 5 月期间肺部病变并同意接受 UG PET/CT 和胸部 RG PET/CT（包括基于相位的静止期门控、pQPG 和相位匹配 4D PET/CT、4DRG）。从每次扫描的 PET 图像中提取 377 个放射组学特征。配对 t 检验用于比较 UG 和 RG 特征以进行扫描间变异性分析。我们开发了三种具有 UG 和 RG 特征的放射组学模型（即 UGModel、pQPGModel 和 4DRGModel）。采用ROC曲线比较诊断效率，并通过五倍交叉验证进行模型水平的诊断价值比较。 P 值 < 0.05 被认为具有统计显着性。 共有 111 名患者（平均年龄 ± 标准差为 59.1 ± 11.6 岁，范围为 29 - 88 岁，其中 63 名是男性），有 209 个肺部病变，分析了特征变异性和纳入PET/CT前未经治疗的91例患者的126个非转移病灶亚组进行诊断分析。 101/377 (26.8%) 4DRG 特征和 82/377 (21.8%) pQPG 特征与 UG 特征相比显示出显着差异（均 P<0.05）。其中61/377（16.2%）和59/377（15.6%）在恶性识别中分别表现出明显更好的判别能力（ΔAUC%（即（AUCRG - AUCUG）/ AUCUG×100%）> 0和P<0.05） 。对于模型级比较，与 UGModel（sen 57.7 %，spe 76.4 %）和 pQPGModel（sen 63.4 %，spe 81.8 %）相比，4DRGModel 实现了最高的诊断功效（sen 73.2 %，spe 87.3 %）。RG PET/CT与 UG PET/CT 相比，在肺部病变代谢异质性的定量评估和 NSCLC 患者的后续诊断方面表现更好。版权所有 © 2024。由 Elsevier B.V. 出版。

To investigate the variability and diagnostic efficacy of respiratory-gated (RG) PET/CT based radiomics features compared to ungated (UG) PET/CT in the differentiation of non-small cell lung cancer (NSCLC) and benign lesions.117 patients with suspected lung lesions from March 2020 to May 2021 and consent to undergo UG PET/CT and chest RG PET/CT (including phase-based quiescent period gating, pQPG and phase-matched 4D PET/CT, 4DRG) were prospectively included. 377 radiomics features were extracted from PET images of each scan. Paired t test was used to compare UG and RG features for inter-scan variability analysis. We developed three radiomics models with UG and RG features (i.e. UGModel, pQPGModel and 4DRGModel). ROC curves were used to compare diagnostic efficiencies, and the model-level comparison of diagnostic value was performed by five-fold cross-validation. A P value < 0.05 was considered as statistically significant.A total of 111 patients (average age ± standard deviation was 59.1 ± 11.6 y, range, 29 - 88 y, and 63 were males) with 209 lung lesions were analyzed for features variability and the subgroup of 126 non-metastasis lesions in 91 patients without treatment before PET/CT were included for diagnosis analysis. 101/377 (26.8 %) 4DRG features and 82/377 (21.8 %) pQPG features showed significant difference compared to UG features (both P<0.05). 61/377 (16.2 %) and 59/377 (15.6 %) of them showed significantly better discriminant ability (ΔAUC% (i.e. (AUCRG - AUCUG) / AUCUG×100 %) > 0 and P<0.05) in malignant recognition, respectively. For the model-level comparison, 4DRGModel achieved the highest diagnostic efficacy (sen 73.2 %, spe 87.3 %) compared with UGModel (sen 57.7 %, spe 76.4 %) and pQPGModel (sen 63.4 %, spe 81.8 %).RG PET/CT performs better in the quantitative assessment of metabolic heterogeneity for lung lesions and the subsequent diagnosis in patients with NSCLC compared with UG PET/CT.Copyright © 2024. Published by Elsevier B.V.