%0 Journal Article %A H. Kuno %A N. Garg %A M.M. Qureshi %A M.N. Chapman %A B. Li %A S.K. Meibom %A M.T. Truong %A K. Takumi %A O. Sakai %T CT Texture Analysis of Cervical Lymph Nodes on Contrast-Enhanced [18F] FDG-PET/CT Images to Differentiate Nodal Metastases from Reactive Lymphadenopathy in HIV-Positive Patients with Head and Neck Squamous Cell Carcinoma %D 2019 %R 10.3174/ajnr.A5974 %J American Journal of Neuroradiology %X BACKGROUND AND PURPOSE: Differentiating nodal metastases from reactive adenopathy in HIV-infected patients with [18F] FDG-PET/CT can be challenging because lymph nodes in HIV-positive patients often show increased [18F] FDG uptake. The purpose of this study was to assess CT textural analysis characteristics of HIV-positive and HIV-negative lymph nodes on [18F] FDG-PET/CT to differentiate nodal metastases from disease-specific nodal reactivity.MATERIALS AND METHODS: Nine HIV-positive patients with head and neck squamous cell carcinoma (7 men, 2 women; 29–62 years of age; median age, 48 years) with 22 lymph nodes (≥1 cm) who underwent contrast-enhanced CT with [18F] FDG-PET followed by pathologic evaluation of cervical lymph nodes were retrospectively reviewed. Twenty-six HIV-negative patients with head and neck squamous cell carcinoma with 61 lymph nodes were evaluated as a control group. Each lymph node was manually segmented, and an in-house-developed Matlab-based texture analysis program extracted 41 texture features from each segmented volume. A mixed linear regression model was used to compare the pathologically proved malignant lymph nodes with benign nodes in the 2 enrolled groups.RESULTS: Thirteen (59%) lymph nodes in the HIV-positive group and 22 (36%) lymph nodes in the HIV-negative control group were confirmed as positive for metastases. There were 7 histogram features (P = .017–0.032), 3 gray-level co-occurrence features (P = .009-.025), and 9 gray-level run-length features (P < .001–.033) that demonstrated a significant difference in HIV-positive patients with either benign or malignant lymph nodes.CONCLUSIONS: CT texture analysis may be useful as a noninvasive method of obtaining additional quantitative information to differentiate nodal metastases from disease-specific nodal reactivity in HIV-positive patients with head and neck squamous cell carcinoma.AUCarea under receiver operating characteristic curveHNSCChead and neck squamous cell carcinomaGLCMgray-level co-occurrence matrixGLGMgray-level gradient matrixGLNgray-level nonuniformityGLRLgray-level run-lengthHGREhigh gray-level run emphasisLGRElow gray-level run emphasisLRElong-run emphasisLRHGElong-run high gray-level emphasismaxmaximumRLNrun-length nonuniformityRPrun percentageSREshort-run emphasisSRLGEshort-run low gray-level emphasisSUVstandard uptake value %U https://www.ajnr.org/content/ajnr/early/2019/02/21/ajnr.A5974.full.pdf