Joshua Shur1, Matthew Orton1, Ashton Connor2, Sandra Fischer3, Carol-Anne Moulton4, Steven Gallinger4, Dow-Mu Koh1, Kartik S Jhaveri5. 1. Department of Radiology, Royal Marsden Hospital, Sutton, UK. 2. Department of Surgery, Duke University Hospital, Durham, North Carolina. 3. Department of Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada. 4. Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada. 5. Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
BACKGROUND AND OBJECTIVES: Colorectal cancer with liver metastases is potentially curable with surgical resection however clinical prognostic factors can insufficiently stratify patients. This study aims to assess whether radiomic features are prognostic and can inform clinical decision making. METHODS: This single-site retrospective study included 102 patients who underwent colorectal liver metastases resection with preoperative computed tomography (CT), magnetic resonance imaging (MRI) with gadoxetic acid (EOB) and clinical covariates. A lasso-regularized multivariate Cox proportional hazards model was applied to 114 features (10 clinical, 104 radiomic) to determine association with disease-free survival (DFS). A prognostic index was derived using the significant Cox regression coefficients and their corresponding input features and a threshold was determined to classify patients into high- and low-risk groups, and DFS compared using log-rank tests. RESULTS: Four covariates were significantly associated with DFS; bilobar disease (hazard ratio [HR]= 1.56; P = .0043), complete pathological response (HR= 0.67; P = .025), minimum pixel value (HR= 1.66; P = .00016), and small area emphasis (HR= 0.62; P = .0013) from the EOB-MRI data. Radiomic CT features were not prognostic. The prognostic index strongly stratified high- and low-risk prognostic groups (HR = 0.31; P = .00068). CONCLUSION: Radiomic MRI features provided meaningful prognostic information above clinical covariates alone. This merits further validation for potential clinical implementation to inform management.
BACKGROUND AND OBJECTIVES:Colorectal cancer with liver metastases is potentially curable with surgical resection however clinical prognostic factors can insufficiently stratify patients. This study aims to assess whether radiomic features are prognostic and can inform clinical decision making. METHODS: This single-site retrospective study included 102 patients who underwent colorectal liver metastases resection with preoperative computed tomography (CT), magnetic resonance imaging (MRI) with gadoxetic acid (EOB) and clinical covariates. A lasso-regularized multivariate Cox proportional hazards model was applied to 114 features (10 clinical, 104 radiomic) to determine association with disease-free survival (DFS). A prognostic index was derived using the significant Cox regression coefficients and their corresponding input features and a threshold was determined to classify patients into high- and low-risk groups, and DFS compared using log-rank tests. RESULTS: Four covariates were significantly associated with DFS; bilobar disease (hazard ratio [HR]= 1.56; P = .0043), complete pathological response (HR= 0.67; P = .025), minimum pixel value (HR= 1.66; P = .00016), and small area emphasis (HR= 0.62; P = .0013) from the EOB-MRI data. Radiomic CT features were not prognostic. The prognostic index strongly stratified high- and low-risk prognostic groups (HR = 0.31; P = .00068). CONCLUSION: Radiomic MRI features provided meaningful prognostic information above clinical covariates alone. This merits further validation for potential clinical implementation to inform management.
Authors: Lena Maier-Hein; Matthias Eisenmann; Duygu Sarikaya; Keno März; Toby Collins; Anand Malpani; Johannes Fallert; Hubertus Feussner; Stamatia Giannarou; Pietro Mascagni; Hirenkumar Nakawala; Adrian Park; Carla Pugh; Danail Stoyanov; Swaroop S Vedula; Kevin Cleary; Gabor Fichtinger; Germain Forestier; Bernard Gibaud; Teodor Grantcharov; Makoto Hashizume; Doreen Heckmann-Nötzel; Hannes G Kenngott; Ron Kikinis; Lars Mündermann; Nassir Navab; Sinan Onogur; Tobias Roß; Raphael Sznitman; Russell H Taylor; Minu D Tizabi; Martin Wagner; Gregory D Hager; Thomas Neumuth; Nicolas Padoy; Justin Collins; Ines Gockel; Jan Goedeke; Daniel A Hashimoto; Luc Joyeux; Kyle Lam; Daniel R Leff; Amin Madani; Hani J Marcus; Ozanan Meireles; Alexander Seitel; Dogu Teber; Frank Ückert; Beat P Müller-Stich; Pierre Jannin; Stefanie Speidel Journal: Med Image Anal Date: 2021-11-18 Impact factor: 13.828
Authors: Drew Maclean; Maria Tsakok; Fergus Gleeson; David J Breen; Robert Goldin; John Primrose; Adrian Harris; James Franklin Journal: Front Oncol Date: 2021-12-07 Impact factor: 6.244