Lucian Beer1,2,3, Paula Martin-Gonzalez3,4, Maria Delgado-Ortet1,3, Marika Reinius1,3,4, Leonardo Rundo1,3, Ramona Woitek1,2,3, Stephan Ursprung1,3, Lorena Escudero1,3, Hilal Sahin1,3, Ionut-Gabriel Funingana3,4, Joo-Ern Ang3,4,5, Mercedes Jimenez-Linan6, Tristan Lawton7, Gaurav Phadke7, Sally Davey8, Nghia Q Nguyen9, Florian Markowetz3,4, James D Brenton3,4, Mireia Crispin-Ortuzar3,4, Helen Addley1,3,5, Evis Sala10,11. 1. Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK. 2. Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, 1090, Vienna, Austria. 3. Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK. 4. Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, CB2 0RE, UK. 5. Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK. 6. Department of Pathology, Addenbrooke's Hospital, Cambridge, UK. 7. Canon Medical Research Europe Ltd, Edinburgh, UK. 8. Canon Medical Systems LTD, Crawley, UK. 9. Information Engineering Division, Department of Engineering, University of Cambridge, Cambridge, CB2 1PZ, UK. 10. Department of Radiology, University of Cambridge, Cambridge, CB2 0QQ, UK. es220@medschl.cam.ac.uk. 11. Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, CB2 0RE, UK. es220@medschl.cam.ac.uk.
Abstract
PURPOSE: To develop a precision tissue sampling technique that uses computed tomography (CT)-based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC). METHODS: Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy. RESULTS: We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7-30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53). CONCLUSION: We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC. KEY POINTS: • We developed a prevision tissue sampling technique that co-registers CT-based radiomics-based tumour habitats with US images. • The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53).
PURPOSE: To develop a precision tissue sampling technique that uses computed tomography (CT)-based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC). METHODS: Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy. RESULTS: We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7-30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53). CONCLUSION: We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC. KEY POINTS: • We developed a prevision tissue sampling technique that co-registers CT-based radiomics-based tumour habitats with US images. • The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76-0.79) while it was lower for the smaller omental metastases (DSC: 0.37-0.53).
Authors: Amani Arthur; Edward W Johnston; Jessica M Winfield; Matthew D Blackledge; Robin L Jones; Paul H Huang; Christina Messiou Journal: Front Oncol Date: 2022-07-01 Impact factor: 5.738
Authors: Thierry L Lefebvre; Emma Brown; Lina Hacker; Thomas Else; Mariam-Eleni Oraiopoulou; Michal R Tomaszewski; Rajesh Jena; Sarah E Bohndiek Journal: Front Oncol Date: 2022-03-03 Impact factor: 5.738