Hui Xu1, Wenbing Lv1, Hui Feng1, Dongyang Du1, Qingyu Yuan2, Quanshi Wang2, Zhenhui Dai3, Wei Yang1, Qianjin Feng1, Jianhua Ma1, Lijun Lu4. 1. School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China. 2. Nanfang PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China. 3. Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, China. 4. School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, 510515, China. ljlubme@gmail.com.
Abstract
PURPOSE: This work aims to identify intratumoral habitats with distinct heterogeneity based on 2-deoxy-2-[18F]fluro-D-glucose positron emission tomography (PET)/X-ray computed tomography (CT) imaging, and to develop a subregional radiomics approach to predict progression-free survival (PFS) in patients with nasopharyngeal carcinoma (NPC). PROCEDURES: In total, 128 NPC patients (85 vs. 43 for primary vs. validation cohorts) who underwent pre-treatment PET/CT scan were enrolled retrospectively. Each tumor was partitioned into several phenotypically consistent subregions based on individual- and population-level clustering. For each subregion, 202 radiomics features were extracted to construct imaging biomarker for prognosis via Cox's proportional hazard model combined with forward stepwise feature selection. Relevance of imaging biomarkers and clinicopathological factors were assessed by multivariate Cox regression analysis and Spearman's correlation analysis. To investigate whether imaging biomarkers could provide complementary prognosis information beyond existing predictors, a scoring system was further developed for risk stratification and compared with AJCC staging system. RESULTS: Three subregions (denoted as S1, S2, and S3) were discovered with distinct PET/CT imaging characteristics in the two cohorts. The prognostic performance of imaging biomarker S3 outperformed the whole tumor (C-index, 0.69 vs. 0.58; log-rank test, p < 0.001 vs. p = 0.552). Imaging biomarker S3 and AJCC stage were identified as independent predictors (p = 0.011 and 0.042, respectively) after adjusting for clinicopathological factors. The scoring system outperformed the traditional AJCC staging system (log-rank test, p < 0.0001 vs. p = 0.0002 in primary cohort and p = 0.0021 vs. p = 0.0277 in validation cohort, respectively). CONCLUSIONS: Subregional radiomics analysis of PET/CT imaging has the potential to predict PFS in patients with NPC, which also provides complementary prognostic information for traditional predictors.
PURPOSE: This work aims to identify intratumoral habitats with distinct heterogeneity based on 2-deoxy-2-[18F]fluro-D-glucose positron emission tomography (PET)/X-ray computed tomography (CT) imaging, and to develop a subregional radiomics approach to predict progression-free survival (PFS) in patients with nasopharyngeal carcinoma (NPC). PROCEDURES: In total, 128 NPCpatients (85 vs. 43 for primary vs. validation cohorts) who underwent pre-treatment PET/CT scan were enrolled retrospectively. Each tumor was partitioned into several phenotypically consistent subregions based on individual- and population-level clustering. For each subregion, 202 radiomics features were extracted to construct imaging biomarker for prognosis via Cox's proportional hazard model combined with forward stepwise feature selection. Relevance of imaging biomarkers and clinicopathological factors were assessed by multivariate Cox regression analysis and Spearman's correlation analysis. To investigate whether imaging biomarkers could provide complementary prognosis information beyond existing predictors, a scoring system was further developed for risk stratification and compared with AJCC staging system. RESULTS: Three subregions (denoted as S1, S2, and S3) were discovered with distinct PET/CT imaging characteristics in the two cohorts. The prognostic performance of imaging biomarker S3 outperformed the whole tumor (C-index, 0.69 vs. 0.58; log-rank test, p < 0.001 vs. p = 0.552). Imaging biomarker S3 and AJCC stage were identified as independent predictors (p = 0.011 and 0.042, respectively) after adjusting for clinicopathological factors. The scoring system outperformed the traditional AJCC staging system (log-rank test, p < 0.0001 vs. p = 0.0002 in primary cohort and p = 0.0021 vs. p = 0.0277 in validation cohort, respectively). CONCLUSIONS: Subregional radiomics analysis of PET/CT imaging has the potential to predict PFS in patients with NPC, which also provides complementary prognostic information for traditional predictors.
Authors: Ober Van Gómez; Joaquin L Herraiz; José Manuel Udías; Alexander Haug; Laszlo Papp; Dania Cioni; Emanuele Neri Journal: Cancers (Basel) Date: 2022-06-14 Impact factor: 6.575
Authors: Mingquan Lin; Jacob F Wynne; Boran Zhou; Tonghe Wang; Yang Lei; Walter J Curran; Tian Liu; Xiaofeng Yang Journal: J Appl Clin Med Phys Date: 2021-06-24 Impact factor: 2.102