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Yi H, Han Y, Li Q, Lin R, Zhang J, Yang Y, Wang X, Zhang L. Prognostic impact of the combination of HIF‑1α and GLUT1 in patients with oesophageal squamous cell carcinoma. Oncol Lett 2023; 26:404. [PMID: 37600334 PMCID: PMC10433721 DOI: 10.3892/ol.2023.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 09/16/2022] [Indexed: 08/22/2023] Open
Abstract
Oesophageal squamous cell carcinoma (ESCC) is a common type of carcinoma. Hypoxia is associated with chemo- and radio-resistance, which may lead to a poor prognosis. Hypoxia-inducible factor-1α (HIF-1α) is the main transcriptional regulator of the cellular response to low oxygen levels. Moreover, it can trigger the expression of critical genes, including glucose transporter protein type 1 (GLUT1). The aim of the present study was to evaluate the roles of HIF-1α and GLUT1 in ESCC and their usefulness as prognostic markers. HIF-1α and GLUT1 were measured in four ESCC cell lines, namely Eca109, KYSE150, TE-1 and TE-10, by western blotting following culture under normoxic and hypoxic conditions. In addition, xenograft tumors were established in mice using normoxic and hypoxic Eca109 cells and the chemosensitivity of the xenografts to 5-fluorouracil (5-FU) was evaluated. Furthermore, HIF-1α and GLUT1 were analysed by immunochemistry in the tumor tissues of patients with ESCC and the associations of their expression levels with clinicopathological parameters were investigated. The results revealed that HIF-1α and GLUT1 protein expression was weak in all four cell lines under a normoxic atmosphere but increased following culture in a hypoxic environment. In vivo, 5-FU inhibited tumor growth more strongly in normoxic Eca109 ×enografts than hypoxic Eca109 ×enografts. Higher levels of apoptosis were also detected in the normoxic Eca109 ×enografts via western blotting and TUNEL analysis. In patients with ESCC, HIF-1α expression was associated with advanced ESCC while GLUT1 expression was associated with the sex of the patients. Multivariate analysis demonstrated that HIF-1α and GLUT1 were negatively associated with progression-free survival (PFS) and overall survival (OS). Additionally, a combination of HIF-1α and GLUT1 expression was a predictor of RFS and OS in patients with ESCC without lymph node metastasis but not those with lymph node metastasis. The study demonstrated that HIF-1α and GLUT1 were strongly expressed in vitro and in xenograft models when cells were exposed to hypoxia. The simultaneous high expression of HIF-1α and GLUT1 was associated with poorer survival, and may play an important role in ESCC chemoresistance and the prognosis of ESCC.
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Affiliation(s)
- Hanjie Yi
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
- Department of Oncology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Yongqin Han
- Department of Oncology, Shangrao People's Hospital, Shangrao, Jiangxi 334000, P.R. China
| | - Qin Li
- Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330000, P.R. China
| | - Runduan Lin
- Department of Oncology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Jia Zhang
- Department of Laboratory Medicine, The Third Hospital of Changsha, Changsha, Hunan 410015, P.R. China
| | - Yun Yang
- Department of Laboratory Medicine, The 921st Hospital of The Joint Logistics Support Force of The Chinese People's Liberation Army, Changsha, Hunan 410003, P.R. China
| | - Xueping Wang
- Department of Oncology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Lin Zhang
- Department of Oncology, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
- Department of Laboratory Medicine, Yunfu People's Hospital, Yunfu, Guangdong 527300, P.R. China
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The Usefulness of Machine Learning-Based Evaluation of Clinical and Pretreatment [ 18F]-FDG-PET/CT Radiomic Features for Predicting Prognosis in Hypopharyngeal Cancer. Mol Imaging Biol 2023; 25:303-313. [PMID: 35864282 DOI: 10.1007/s11307-022-01757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/06/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To examine whether the machine learning (ML) analyses using clinical and pretreatment 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]-FDG-PET)-based radiomic features were useful for predicting prognosis in patients with hypopharyngeal cancer. PROCEDURES This retrospective study included 100 patients with hypopharyngeal cancer who underwent [18F]-FDG-PET/X-ray computed tomography (CT) before treatment, and these patients were allocated to the training (n=80) and validation (n=20) cohorts. Eight clinical (age, sex, histology, T stage, N stage, M stage, UICC stage, and treatment) and 40 [18F]-FDG-PET-based radiomic features were used to predict disease progression. A feature reduction procedure based on the decrease of the Gini impurity was applied. Six ML algorithms (random forest, neural network, k-nearest neighbors, naïve Bayes, logistic regression, and support vector machine) were compared using the area under the receiver operating characteristic curve (AUC). Progression-free survival (PFS) was assessed using Cox regression analysis. RESULTS The five most important features for predicting disease progression were UICC stage, N stage, gray level co-occurrence matrix entropy (GLCM_Entropy), gray level run length matrix run length non-uniformity (GLRLM_RLNU), and T stage. Patients who experienced disease progression displayed significantly higher UICC stage, N stage, GLCM_Entropy, GLRLM_RLNU, and T stage than those without progression (each, p<0.001). In both cohorts, the logistic regression model constructed by these 5 features was the best performing classifier (training: AUC=0.860, accuracy=0.800; validation: AUC=0.803, accuracy=0.700). In the logistic regression model, 5-year PFS was significantly higher in patients with predicted non-progression than those with predicted progression (75.8% vs. 8.3%, p<0.001), and this model was only the independent factor for PFS in multivariate analysis (hazard ratio = 3.22; 95% confidence interval = 1.03-10.11; p=0.045). CONCLUSIONS The logistic regression model constructed by UICC, T and N stages and pretreatment [18F]-FDG-PET-based radiomic features, GLCM_Entropy, and GLRLM_RLNU may be the most important predictor of prognosis in patients with hypopharyngeal cancer.
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Chiesa-Estomba CM, Mayo-Yanez M, Guntinas-Lichius O, Vander-Poorten V, Takes RP, de Bree R, Halmos GB, Saba NF, Nuyts S, Ferlito A. Radiomics in Hypopharyngeal Cancer Management: A State-of-the-Art Review. Biomedicines 2023; 11:biomedicines11030805. [PMID: 36979783 PMCID: PMC10045560 DOI: 10.3390/biomedicines11030805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/25/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
(1) Background: Hypopharyngeal squamous cell carcinomas usually present with locally advanced disease and a correspondingly poor prognosis. Currently, efforts are being made to improve tumor characterization and provide insightful information for outcome prediction. Radiomics is an emerging area of study that involves the conversion of medical images into mineable data; these data are then used to extract quantitative features based on shape, intensity, texture, and other parameters; (2) Methods: A systematic review of the peer-reviewed literature was conducted; (3) Results: A total of 437 manuscripts were identified. Fifteen manuscripts met the inclusion criteria. The main targets described were the evaluation of textural features to determine tumor-programmed death-ligand 1 expression; a surrogate for microvessel density and heterogeneity of perfusion; patient stratification into groups at high and low risk of progression; prediction of early recurrence, 1-year locoregional failure and survival outcome, including progression-free survival and overall survival, in patients with locally advanced HPSCC; thyroid cartilage invasion, early disease progression, recurrence, induction chemotherapy response, treatment response, and prognosis; and (4) Conclusions: our findings suggest that radiomics represents a potentially useful tool in the diagnostic workup as well as during the treatment and follow-up of patients with HPSCC. Large prospective studies are essential to validate this technology in these patients.
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Affiliation(s)
- Carlos M. Chiesa-Estomba
- Otorhinolaryngology-Head & Neck Surgery Department, Hospital Universitario Donostia, Biodonostia Research Institute, Faculty of Medicine, Deusto University, 20014 San Sebastian, Spain
- Correspondence:
| | - Miguel Mayo-Yanez
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Spain
| | | | - Vincent Vander-Poorten
- Section Head and Neck Oncology, Department of Oncology, KU Leuven—University of Leuven, 3000 Leuven, Belgium
| | - Robert P. Takes
- Department of Otolaryngology/Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Gyorgy B. Halmos
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
| | - Nabil F. Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA
| | - Sandra Nuyts
- Department of Radiation Oncology, University Hospitals Leuven, KU Leuven—University of Leuven, 3000 Leuven, Belgium
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35125 Padua, Italy
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Liu H, Zhao D, Huang Y, Li C, Dong Z, Tian H, Sun Y, Lu Y, Chen C, Wu H, Zhang Y. Comprehensive prognostic modeling of locoregional recurrence after radiotherapy for patients with locoregionally advanced hypopharyngeal squamous cell carcinoma. Front Oncol 2023; 13:1129918. [PMID: 37025592 PMCID: PMC10072214 DOI: 10.3389/fonc.2023.1129918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/13/2023] [Indexed: 04/08/2023] Open
Abstract
Purpose To propose and evaluate a comprehensive modeling approach combing radiomics, dosiomics and clinical components, for more accurate prediction of locoregional recurrence risk after radiotherapy for patients with locoregionally advanced HPSCC. Materials and methods Clinical data of 77 HPSCC patients were retrospectively investigated, whose median follow-up duration was 23.27 (4.83-81.40) months. From the planning CT and dose distribution, 1321 radiomics and dosiomics features were extracted respectively from planning gross tumor volume (PGTV) region each patient. After stability test, feature dimension was further reduced by Principal Component Analysis (PCA), yielding Radiomic and Dosiomic Principal Components (RPCs and DPCs) respectively. Multiple Cox regression models were constructed using various combinations of RPC, DPC and clinical variables as the predictors. Akaike information criterion (AIC) and C-index were used to evaluate the performance of Cox regression models. Results PCA was performed on 338 radiomic and 873 dosiomic features that were tested as stable (ICC1 > 0.7 and ICC2 > 0.95), yielding 5 RPCs and DPCs respectively. Three comprehensive features (RPC0, P<0.01, DPC0, P<0.01 and DPC3, P<0.05) were found to be significant in the individual Radiomic or Dosiomic Cox regression models. The model combining the above features and clinical variable (total stage IVB) provided best risk stratification of locoregional recurrence (C-index, 0.815; 95%CI, 0.770-0.859) and prevailing balance between predictive accuracy and complexity (AIC, 143.65) than any other investigated models using either single factors or two combined components. Conclusion This study provided quantitative tools and additional evidence for the personalized treatment selection and protocol optimization for HPSCC, a relatively rare cancer. By combining complementary information from radiomics, dosiomics, and clinical variables, the proposed comprehensive model provided more accurate prediction of locoregional recurrence risk after radiotherapy.
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Affiliation(s)
- Hongjia Liu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Dan Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yuliang Huang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Chenguang Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhengkun Dong
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Hongbo Tian
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yijie Sun
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Yanye Lu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Chen Chen
- School of Electronics Engineering and Computer Science, Peking University, Beijing, China
| | - Hao Wu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yibao Zhang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China
- *Correspondence: Yibao Zhang,
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Liu X, Long M, Sun C, Yang Y, Lin P, Shen Z, Xia S, Shen W. CT-based radiomics signature analysis for evaluation of response to induction chemotherapy and progression-free survival in locally advanced hypopharyngeal carcinoma. Eur Radiol 2022; 32:7755-7766. [PMID: 35608663 DOI: 10.1007/s00330-022-08859-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/28/2022] [Accepted: 05/01/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To establish and validate a CT radiomics model for prediction of induction chemotherapy (IC) response and progression-free survival (PFS) among patients with locally advanced hypopharyngeal carcinoma (LAHC). METHODS One hundred twelve patients with LAHC (78 in training cohort and 34 in validation cohort) who underwent contrast-enhanced CT (CECT) scans prior to IC were enrolled. Least absolute shrinkage and selection operator (LASSO) was used to select the crucial radiomic features in the training cohort. Radiomics signature and clinical data were used to build a radiomics nomogram to predict individual response to IC. Kaplan-Meier analysis and log-rank test were used to evaluate ability of radiomics signature in progression-free survival risk stratification. RESULTS The radiomics signature consisted of 6 selected features from the arterial and venous phases of CECT images and demonstrated good performance in predicting the IC response in both two cohorts. The radiomics nomogram showed good discriminative performance, and the C-index of nomogram was 0.899 (95% confidence interval (CI), 0.831-0.967) and 0.775 (95% CI, 0.591-0.959) in the training and validation cohorts, respectively. Survival analysis indicated that low-risk and high-risk groups defined by the value of radiomics signature had significant difference in PFS (3-year PFS 66.4% vs 29.7%, p < 0.001). CONCLUSIONS Multiparametric CT-based radiomics model could be useful for predicting treatment response and PFS in patients with LAHC who underwent IC. KEY POINTS • CT radiomics can predict IC response and progression-free survival in hypopharyngeal carcinoma. • We combined significant radiomics signature with clinical predictors to establish a nomogram to predict individual response to IC. • Radiomics signature could divide patients into the high-risk and low-risk groups based on the PFS.
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Affiliation(s)
- Xiaobin Liu
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, 300192, Tianjin, China
| | - Miaomiao Long
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, 300192, Tianjin, China
| | - Chuanqi Sun
- Department of Biomedical Engineering, Guangzhou Medical University, Xinzao Road No. 1, Panyu District, Guangzhou, 511436, China
| | - Yining Yang
- Department of Radiotherapy, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Peng Lin
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Zhiwei Shen
- Philips Healthcare, World Profit Centre, 100125, Tianze Road No. 16, Chaoyang District, Beijing, China
| | - Shuang Xia
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, 300192, Tianjin, China.
| | - Wen Shen
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, 300192, Tianjin, China.
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Li C, Wang S, Li C, Yin Y, Feng F, Fu H, Wang H, Chen S. Improved risk stratification by PET-based intratumor heterogeneity in children with high-risk neuroblastoma. Front Oncol 2022; 12:896593. [PMID: 36353561 PMCID: PMC9637983 DOI: 10.3389/fonc.2022.896593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/20/2022] [Indexed: 11/12/2023] Open
Abstract
PURPOSE The substratification of high-risk neuroblastoma is challenging, and new predictive imaging biomarkers are warranted for better patient selection. The aim of the study was to evaluate the prognostic role of PET-based intratumor heterogeneity and its potential ability to improve risk stratification in neuroblastoma. METHODS Pretreatment 18F-FDG PET/CT scans from 112 consecutive children with newly diagnosed neuroblastoma were retrospectively analyzed. The primary tumor was segmented in the PET images. SUVs, volumetric parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG), and texture features were extracted. After the exclusion of imaging features with poor and moderate reproducibility, the relationships between the imaging indices and clinicopathological factors, as well as event-free survival (EFS), were assessed. RESULTS The median follow-up duration was 33 months. Multivariate analysis showed that PET-based intratumor heterogeneity outperformed clinicopathological features, including age, stage, and MYCN, and remained the most robust independent predictor for EFS [training set, hazard ratio (HR): 6.4, 95% CI: 3.1-13.2, p < 0.001; test set, HR: 5.0, 95% CI: 1.8-13.6, p = 0.002]. Within the clinical high-risk group, patients with a high metabolic heterogeneity showed significantly poorer outcomes (HR: 3.3, 95% CI: 1.6-6.8, p = 0.002 in the training set; HR: 4.4, 95% CI: 1.5-12.9, p = 0.008 in the test set) compared to those with relatively homogeneous tumors. Furthermore, intratumor heterogeneity outran the volumetric indices (MTVs and TLGs) and yielded the best performance of distinguishing high-risk patients with different outcomes with a 3-year EFS of 6% vs. 47% (p = 0.001) in the training set and 9% vs. 51% (p = 0.004) in the test set. CONCLUSION PET-based intratumor heterogeneity was a strong independent prognostic factor in neuroblastoma. In the clinical high-risk group, intratumor heterogeneity further stratified patients with distinct outcomes.
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Affiliation(s)
- Chao Li
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaoyan Wang
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Can Li
- Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yafu Yin
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Feng
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongliang Fu
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Suyun Chen
- Department of Nuclear Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Morland D, Triumbari EKA, Boldrini L, Gatta R, Pizzuto D, Annunziata S. Radiomics in Oncological PET Imaging: A Systematic Review—Part 1, Supradiaphragmatic Cancers. Diagnostics (Basel) 2022; 12:diagnostics12061329. [PMID: 35741138 PMCID: PMC9221970 DOI: 10.3390/diagnostics12061329] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 12/10/2022] Open
Abstract
Radiomics is an upcoming field in nuclear oncology, both promising and technically challenging. To summarize the already undertaken work on supradiaphragmatic neoplasia and assess its quality, we performed a literature search in the PubMed database up to 18 February 2022. Inclusion criteria were: studies based on human data; at least one specified tumor type; supradiaphragmatic malignancy; performing radiomics on PET imaging. Exclusion criteria were: studies only based on phantom or animal data; technical articles without a clinically oriented question; fewer than 30 patients in the training cohort. A review database containing PMID, year of publication, cancer type, and quality criteria (number of patients, retrospective or prospective nature, independent validation cohort) was constructed. A total of 220 studies met the inclusion criteria. Among them, 119 (54.1%) studies included more than 100 patients, 21 studies (9.5%) were based on prospectively acquired data, and 91 (41.4%) used an independent validation set. Most studies focused on prognostic and treatment response objectives. Because the textural parameters and methods employed are very different from one article to another, it is complicated to aggregate and compare articles. New contributions and radiomics guidelines tend to help improving quality of the reported studies over the years.
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Affiliation(s)
- David Morland
- Nuclear Medicine Unit, TracerGLab, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.K.A.T.); (D.P.); (S.A.)
- Service de Médecine Nucléaire, Institut Godinot, 51100 Reims, France
- Laboratoire de Biophysique, UFR de Médecine, Université de Reims Champagne-Ardenne, 51100 Reims, France
- CReSTIC (Centre de Recherche en Sciences et Technologies de l’Information et de la Communication), EA 3804, Université de Reims Champagne-Ardenne, 51100 Reims, France
- Correspondence:
| | - Elizabeth Katherine Anna Triumbari
- Nuclear Medicine Unit, TracerGLab, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.K.A.T.); (D.P.); (S.A.)
| | - Luca Boldrini
- Radiotherapy Unit, Radiomics, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (L.B.); (R.G.)
| | - Roberto Gatta
- Radiotherapy Unit, Radiomics, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (L.B.); (R.G.)
- Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
- Department of Oncology, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Daniele Pizzuto
- Nuclear Medicine Unit, TracerGLab, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.K.A.T.); (D.P.); (S.A.)
| | - Salvatore Annunziata
- Nuclear Medicine Unit, TracerGLab, Department of Radiology, Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (E.K.A.T.); (D.P.); (S.A.)
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Liu X, Sun C, Long M, Yang Y, Lin P, Xia S, Shen W. Computed tomography-based radiomics signature as a pretreatment predictor of progression-free survival in locally advanced hypopharyngeal carcinoma with a different response to induction chemotherapy. Eur Arch Otorhinolaryngol 2022; 279:3551-3562. [PMID: 35212776 DOI: 10.1007/s00405-022-07306-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/07/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To establish and validate a radiomics signature for stratifying the risk of progression-free survival (PFS) in patients with locally advanced hypopharyngeal carcinoma (LAHC) undergoing induction chemotherapy (IC). METHODS We extracted radiomics features from baseline contrast-enhanced computed tomography (CECT) images. We enrolled 112 LAHC patients (78 in the training cohort and 34 in the validation cohort). We used cox regression model and random survival forests variable hunting (RSFVH) algorithm for feature selection and radiomics signature building. The radiomics signature was established in the training cohort and tested in the validation cohort. We used the Kaplan-Meier analysis and log-rank test to evaluate the ability of radiomics signature in PFS risk stratification among patients with different IC responses and constructed a radiomics nomogram to predict individual PFS risk. RESULTS The radiomics signature performed well in stratifying patients into highrisk and low-risk groups of progression in both the training and validation cohorts. The radiomics nomogram showed good discriminative ability for predicting PFS. Survival outcome analysis of subsets indicated that the radiomics signature performed well in stratifying the risk of PFS in patients with LAHC with different IC responses. CONCLUSIONS The radiomics signature was a pretreatment predictor for PFS in patients with LAHC who exhibited different responses to IC.
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Affiliation(s)
- Xiaobin Liu
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Qixiangtai Road No. 22, Heping District, Tianjin, 300070, China
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Chuanqi Sun
- Department of Biomedical Engineering, Guangzhou Medical University, Xinzao Road No. 1, Panyu District, Guangzhou, 511436, China
| | - Miaomiao Long
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Yining Yang
- Department of Radiotherapy, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Peng Lin
- Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Shuang Xia
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China
| | - Wen Shen
- Department of Radiology, Tianjin Medical Imaging Institute, Tianjin First Central Hospital, School of Medicine, Nankai University, Fukang Road No. 24, Nankai District, Tianjin, 300192, China.
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Shao D, Du D, Liu H, Lv J, Cheng Y, Zhang H, Lv W, Wang S, Lu L. Identification of Stage IIIC/IV EGFR-Mutated Non-Small Cell Lung Cancer Populations Sensitive to Targeted Therapy Based on a PET/CT Radiomics Risk Model. Front Oncol 2021; 11:721318. [PMID: 34796106 PMCID: PMC8593197 DOI: 10.3389/fonc.2021.721318] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives This project aimed to construct an individualized PET/CT prognostic biomarker to accurately quantify the progression risk of patients with stage IIIC-IV epidermal growth factor receptor (EGFR)-mutated Non-small cell lung cancer (NSCLC) after first-line first and second generation EGFR- tyrosine kinase inhibitor (TKI) drug therapy and identify the first and second generation EGFR-TKI treatment-sensitive population. Methods A total of 250 patients with stage IIIC-IV EGFR-mutated NSCLC underwent first-line first and second generation EGFR-TKI drug therapy were included from two institutions (140 patients in training cohort; 60 patients in internal validation cohort, and 50 patients in external validation cohort). 1037 3D radiomics features were extracted to quantify the phenotypic characteristics of the tumor region in PET and CT images, respectively. A four-step feature selection method was performed to enable derivation of stable and effective signature in the training cohort. According to the median value of radiomics signature score (Rad-score), patients were divided into low- and high-risk groups. The progression-free survival (PFS) behaviors of the two subgroups were compared by Kaplan–Meier survival analysis. Results Our results shown that higher Rad-scores were significantly associated with worse PFS in the training (p < 0.0001), internal validation (p = 0.0153), and external validation (p = 0.0006) cohorts. Rad-score can effectively identify patients with a high risk of rapid progression. The Kaplan–Meier survival curves of the three cohorts present significant differences in PFS between the stratified slow and rapid progression subgroups. Conclusion The PET/CT-derived Rad-score can realize the precise quantitative stratification of progression risk after first-line first and second generation EGFR-TKI drug therapy for NSCLC and identify EGFR-mutated NSCLC populations sensitive to targeted therapy, which might help to provide precise treatment options for NSCLC.
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Affiliation(s)
- Dan Shao
- Department of Positron Emission Tomography (PET) Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Dongyang Du
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
| | - Haiping Liu
- Department of Positron Emission Tomography/Computed Tomography (PET/CT) Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jieqin Lv
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
| | - You Cheng
- Department of Positron Emission Tomography (PET) Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hao Zhang
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
| | - Wenbing Lv
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
| | - Shuxia Wang
- Department of Positron Emission Tomography (PET) Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lijun Lu
- School of Biomedical Engineering and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
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10
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A Systematic Review of PET Textural Analysis and Radiomics in Cancer. Diagnostics (Basel) 2021; 11:diagnostics11020380. [PMID: 33672285 PMCID: PMC7926413 DOI: 10.3390/diagnostics11020380] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/10/2021] [Accepted: 02/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Although many works have supported the utility of PET radiomics, several authors have raised concerns over the robustness and replicability of the results. This study aimed to perform a systematic review on the topic of PET radiomics and the used methodologies. Methods: PubMed was searched up to 15 October 2020. Original research articles based on human data specifying at least one tumor type and PET image were included, excluding those that apply only first-order statistics and those including fewer than 20 patients. Each publication, cancer type, objective and several methodological parameters (number of patients and features, validation approach, among other things) were extracted. Results: A total of 290 studies were included. Lung (28%) and head and neck (24%) were the most studied cancers. The most common objective was prognosis/treatment response (46%), followed by diagnosis/staging (21%), tumor characterization (18%) and technical evaluations (15%). The average number of patients included was 114 (median = 71; range 20–1419), and the average number of high-order features calculated per study was 31 (median = 26, range 1–286). Conclusions: PET radiomics is a promising field, but the number of patients in most publications is insufficient, and very few papers perform in-depth validations. The role of standardization initiatives will be crucial in the upcoming years.
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11
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Abstract
Deep learning (DL) approaches to medical image analysis tasks have recently become popular; however, they suffer from a lack of human interpretability critical for both increasing understanding of the methods' operation and enabling clinical translation. This review summarizes currently available methods for performing image model interpretation and critically evaluates published uses of these methods for medical imaging applications. We divide model interpretation in two categories: (1) understanding model structure and function and (2) understanding model output. Understanding model structure and function summarizes ways to inspect the learned features of the model and how those features act on an image. We discuss techniques for reducing the dimensionality of high-dimensional data and cover autoencoders, both of which can also be leveraged for model interpretation. Understanding model output covers attribution-based methods, such as saliency maps and class activation maps, which produce heatmaps describing the importance of different parts of an image to the model prediction. We describe the mathematics behind these methods, give examples of their use in medical imaging, and compare them against one another. We summarize several published toolkits for model interpretation specific to medical imaging applications, cover limitations of current model interpretation methods, provide recommendations for DL practitioners looking to incorporate model interpretation into their task, and offer general discussion on the importance of model interpretation in medical imaging contexts.
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Affiliation(s)
- Daniel T. Huff
- Department of Medical Physics, University of Wisconsin-Madison, Madison WI
| | - Amy J. Weisman
- Department of Medical Physics, University of Wisconsin-Madison, Madison WI
| | - Robert Jeraj
- Department of Medical Physics, University of Wisconsin-Madison, Madison WI
- Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
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12
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Suarez-Weiss KE, Herold A, Gervais D, Palmer E, Amorim B, King JD, Weier L, Shahein T, Bernstine H, Domachevsk L, Cañamaque LG, Herrmann K, Umutlu L, Groshar D, Catalano OA. Hybrid imaging of the abdomen and pelvis. Radiologe 2021; 60:80-89. [PMID: 32424463 DOI: 10.1007/s00117-020-00661-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Accurate imaging is crucial for lesion detection in abdominal organs, for the noninvasive characterization of focal and diffuse abnormalities, and for surgical planning. To accomplish these tasks, several imaging modalities such as multidetector computer tomography (MDCT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) are used for abdominal imaging, providing important morphological, functional or metabolic information. More recently, PET/MRI has been gaining attention due to the possibility of combining high-resolution imaging with metabolic imaging. PET/MRI is a novel hybrid imaging technology that in the near future might play a pivotal role in the clinical management of oncologic and inflammatory abdominopelvic diseases. Despite the still limited number of published clinical studies, PET/MRI has been proven to be at least equivalent to PET/CT and to standalone MRI in a variety of oncologic disease. Moreover, in selected and focused clinical studies, it has been proven to outperform current standard of care imaging, for example, in evaluating cholangiocarcinomas, liver metastases, untreated and treated rectal cancer. This has also had an impact on therapeuticmanagement in some studies. Therefore in some institutions, including those of the authors, PET/MRI is becoming the new standard imaging modality in staging treatment-naïve intrahepatic massforming cholangiocarcinomas and prior to complicated hepatic surgery.
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Affiliation(s)
| | | | - Debra Gervais
- Division of Abdominal Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Edwin Palmer
- Division of Abdominal Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Joseph D King
- Division of Abdominal Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Li Weier
- Division of Abdominal Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Tajmir Shahein
- Division of Abdominal Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | | | | | | | - Onofrio A Catalano
- Division of Abdominal Radiology, Massachusetts General Hospital, Boston, MA, USA.
- University of Naples Parthenope, Naples, Italy.
- Harvard Medical School, Massachusetts General Hospital, 55 Fruits St, Boston, MA, USA.
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Ihara-Nishishita A, Norikane T, Mitamura K, Yamamoto Y, Fujimoto K, Takami Y, Ibuki E, Kudomi N, Hoshikawa H, Toyohara J, Nishiyama Y. Texture indices of 4'-[methyl- 11C]-thiothymidine uptake predict p16 status in patients with newly diagnosed oropharyngeal squamous cell carcinoma: comparison with 18F-FDG uptake. Eur J Hybrid Imaging 2020; 4:20. [PMID: 34191155 PMCID: PMC8218132 DOI: 10.1186/s41824-020-00090-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background In oropharyngeal squamous cell carcinoma (OPSCC), human papillomavirus (HPV)/p16 status is important as a prognostic biomarker. Purpose We evaluated the relationship between 4′-[methyl-11C]-thiothymidine (11C-4DST) and 18F-FDG PET texture indices and p16 status in patients with newly diagnosed OPSCC. Methods We retrospectively reviewed the collected data of 256 consecutive, previously untreated patients with primary head and neck tumors enrolled between November 2011 and October 2019. Complete data on both 11C-4DST and 18F-FDG PET/CT studies before therapy, patients with OPSCC, and p16 status were available for 34 patients. Six of them were excluded because they did not exhibit sufficient 11C-4DST and/or 18F-FDG tumor uptake to perform textural analysis. Finally, 28 patients with newly diagnosed OPSCC were investigated. The maximum standardized uptake value (SUVmax) and 6 texture indices (homogeneity, entropy, short-run emphasis, long-run emphasis, low gray-level zone emphasis, and high gray-level zone emphasis) were derived from PET images. The presence of p16 expression in tumor specimens was examined by immunohistochemistry and compared with the PET parameters. Results Using 11C-4DST, the expression of p16 was associated with a higher homogeneity (P = 0.012), lower short-run emphasis (P = 0.005), higher long-run emphasis (P = 0.009), and lower high-gray-level-zone emphasis (P = 0.042) values. There was no significant difference between 18F-FDG PET parameters and p16 status. Conclusion Texture indices of the primary tumor on 11C-4DST PET, but not 18F-FDG PET, may be of value in predicting the condition’s p16 status in patients with newly diagnosed OPSCC.
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Affiliation(s)
- Ayumi Ihara-Nishishita
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Takashi Norikane
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Katsuya Mitamura
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Yuka Yamamoto
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
| | - Kengo Fujimoto
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Yasukage Takami
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
| | - Emi Ibuki
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Nobuyuki Kudomi
- Department of Medical Physics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hiroshi Hoshikawa
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Jun Toyohara
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshihiro Nishiyama
- Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan
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14
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Value of interim 18F-FDG PET/CT for predicting progression-free survival in stage ⅢB/IV EGFR-mutant non-small-cell lung cancer patients with EGFR-TKI therapy. Lung Cancer 2020; 149:137-143. [PMID: 33011375 DOI: 10.1016/j.lungcan.2020.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/11/2020] [Accepted: 09/23/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES We retrospectively investigated the prognostic value of FDG-PET performed for patients with Stage ⅢB/IV EGFR-mutant non-small-cell lung cancer (NSCLC) receiving EGFR tyrosine kinase inhibitor (TKI) therapy. METHODS A total of 78 patients newly diagnosed with Stage ⅢB/IV EGFR-mutant NSCLC who received baseline and interim PET/CT examination and were treated with EGFR-TKI therapy were included. Interim PET was performed after 4-6 weeks of treatment. Cox proportional hazards regression analysis was used to assess the association between quantitative 18F-FDG PET/CT parameters, other clinicopathological factors and progression-free survival (PFS), non-durable clinical benefit (non-DCB). Five interim PET variables were analyzed in this study in the prediction of non-DCB. RESULTS The one-year and two-year progression-free survival rates of the patients were 33.9% (28.6-39.2%) and 20.7% (16.1-25.3%), respectively. Multivariable analysis indicated that interim PET relevant factors ΔSUVmax (p = 0.002, p = 0.014) and ΔSUVmean (p = 0.000, p = 0.030) were independent risk factors for predicting the PFS or non-DCB of patients receiving EGFR-TKI treatment. The optimal cutoff values of the parameters in the tumor survival analyses were 56.74% for ΔSUVmax (p = 0.002) and 36.48% for ΔSUVmean (p = 0.001). ΔSUVmax had the highest diagnostic value in the prediction of non-DCB. The one-year progression-free survival rates (95% confidence intervals) of patients with ΔSUVmax ≥ 56.74% and ΔSUVmax <56.74% were 59.5% (44.2-74.8%) and 5.7% (0.0-13.3%), respectively (p = 0.000). CONCLUSION An early PET scan after 4-6 weeks can effectively predict the PFS and non-DCB of patients with Stage ⅢB/IV EGFR-mutant NSCLC receiving EGFR-TKI therapy.
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15
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Morand GB, Broglie MA, Schumann P, Huellner MW, Rupp NJ. Histometabolic Tumor Imaging of Hypoxia in Oral Cancer: Clinicopathological Correlation for Prediction of an Aggressive Phenotype. Front Oncol 2020; 10:1670. [PMID: 32984043 PMCID: PMC7481376 DOI: 10.3389/fonc.2020.01670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/28/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Fluorodeoxyglucose-positron emission tomography (FDG-PET) is a widely used imaging tool for oral squamous cell carcinoma (OSCC). Preliminary studies indicate that quantification of tumor metabolic uptake may correlate with tumor hypoxia and aggressive phenotypes. Methods Retrospective review of a consecutive cohort of OSCC (n = 98) with available pretherapeutic FDG-PET/CT, treated at the University Hospital Zurich. Clinico-pathologico-radiological correlation between maximum standard uptake value (SUVmax) of the primary tumor, immunohistochemical staining for hypoxia-related proteins glucose transporter 1 (GLUT1) and hypoxia-inducible factor 1-alpha (HIF1a), depth of invasion (DOI), lymph node metastasis, and outcome was examined. Results Positive staining for GLUT1 and HIF1a on immunohistopathological analysis correlated with increased SUVmax on pretherapeutic imaging and with increased DOI (Kruskal–Wallis, P = 0.037, and P = 0.008, respectively). SUVmax and DOI showed a strong positive correlation (Spearman Rho, correlation coefficient = 0.451, P = 0.0003). An increase in SUVmax predicted nodal metastasis (Kruskal–Wallis, P = 0.017) and poor local control (log rank, P = 0.047). Conclusion In OSCC, FDG-PET-derived metabolic tumor parameter SUVmax serves as a surrogate marker for hypoxia and can be used to predict tumor aggressiveness, with more invasive phenotypes and poorer local control.
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Affiliation(s)
- Grégoire B Morand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Paul Schumann
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Martin W Huellner
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.,Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
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16
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Mo X, Wu X, Dong D, Guo B, Liang C, Luo X, Zhang B, Zhang L, Dong Y, Lian Z, Liu J, Pei S, Huang W, Ouyang F, Tian J, Zhang S. Prognostic value of the radiomics-based model in progression-free survival of hypopharyngeal cancer treated with chemoradiation. Eur Radiol 2020; 30:833-843. [PMID: 31673835 DOI: 10.1007/s00330-019-06452-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/27/2019] [Accepted: 09/12/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE To develop a radiomics-based model to stratify the risk of early progression (local/regional recurrence or metastasis) among patients with hypopharyngeal cancer undergoing chemoradiotherapy and modify their pretreatment plans. MATERIALS AND METHODS We randomly assigned 113 patients into two cohorts: training (n = 80) and validation (n = 33). The radiomic significant features were selected in the training cohort using least absolute shrinkage and selection operator and Akaike information criterion methods, and they were used to build the radiomic model. The concordance index (C-index) was applied to evaluate the model's prognostic performance. A Kaplan-Meier analysis and the log-rank test were used to assess risk stratification ability of models in predicting progression. A nomogram was plotted to predict individual risk of progression. RESULTS Composed of four significant features, the radiomic model showed good performance in stratifying patients into high- and low-risk groups of progression in both the training and validation cohorts (log-rank test, p = 0.00016, p = 0.0063, respectively). Peripheral invasion and metastasis were selected as significant clinical variables. The combined radiomic-clinical model showed good discriminative performance, with C-indices 0.804 (95% confidence interval (CI), 0.688-0.920) and 0.756 (95% CI, 0.605-0.907) in the training and validation cohorts, respectively. The median progression-free survival (PFS) in the high-risk group was significantly shorter than that in the low-risk group in the training (median PFS, 9.5 m and 19.0 m, respectively; p [log-rank] < 0.0001) and validation (median PFS, 11.3 m and 22.5 m, respectively; p [log-rank] = 0.0063) cohorts. CONCLUSIONS A radiomics-based model was established to predict the risk of progression in hypopharyngeal cancer with chemoradiotherapy. KEY POINTS • Clinical information showed limited performance in stratifying the risk of progression among patients with hypopharyngeal cancer. • Imaging features extracted from CECT and NCCT images were independent predictors of PFS. • We combined significant features and valuable clinical variables to establish a nomogram to predict individual risk of progression.
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Affiliation(s)
- Xiaokai Mo
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
- Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Xiangjun Wu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, No. 95 Zhongguancun East Road, Hai Dian District, Beijing, 100190, People's Republic of China
- University of Chinese Academy of Sciences, Beijing, 100190, People's Republic of China
| | - Di Dong
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, No. 95 Zhongguancun East Road, Hai Dian District, Beijing, 100190, People's Republic of China
- University of Chinese Academy of Sciences, Beijing, 100190, People's Republic of China
| | - Baoliang Guo
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Changhong Liang
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Xiaoning Luo
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
- Department of Otolaryngology-Head and Neck Surgery, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Bin Zhang
- Department of Radiology, The First Affiliated Hospital, Jinan University, No. 613, Huangpu West Road, Tianhe District, Guangzhou, Guangdong, 510627, People's Republic of China
| | - Lu Zhang
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Yuhao Dong
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
- Shantou University Medical College, Shantou, Guangdong, People's Republic of China
| | - Zhouyang Lian
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Jing Liu
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Shufang Pei
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Wenhui Huang
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Fusheng Ouyang
- Department of Radiology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, People's Republic of China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, No. 95 Zhongguancun East Road, Hai Dian District, Beijing, 100190, People's Republic of China.
- University of Chinese Academy of Sciences, Beijing, 100190, People's Republic of China.
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, 100191, People's Republic of China.
| | - Shuixing Zhang
- Department of Radiology, The First Affiliated Hospital, Jinan University, No. 613, Huangpu West Road, Tianhe District, Guangzhou, Guangdong, 510627, People's Republic of China.
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Han S, Huang T, Hou F, Yao L, Wang X, Wu X. The prognostic value of hypoxia-inducible factor-1α in advanced cancer survivors: a meta-analysis with trial sequential analysis. Ther Adv Med Oncol 2019; 11:1758835919875851. [PMID: 31579115 PMCID: PMC6759726 DOI: 10.1177/1758835919875851] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 08/19/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Expression of hypoxia-inducible factors (HIFs) has been observed, but their prognostic role in advanced cancers remains uncertain. We conducted a meta-analysis to establish the prognostic effect of HIFs and to better guide treatment planning for advanced cancers. Methods: Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Trial sequential analysis (TSA) was also performed. The clinical outcomes included overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), cancer-specific survival (CSS), relapse/recurrence-free survival (RFS), and metastasis-free survival (MFS) in patients with advanced tumors according to multivariate analysis. Results: A total of 31 studies including 3453 cases who received chemotherapy, radiotherapy, or chemoradiotherapy were identified. Pooled analyses revealed that HIF-1α expression was correlated with worse OS (HR = 1.61, p < 0.001), DFS (HR = 1.61, p < 0.001), PFS (HR = 1.49, p = 0.01), CSS (HR = 1.65, p = 0.056), RFS (HR = 2.10, p = 0.015), or MFS (HR = 2.36, p = 0.002) in advanced cancers. HIF-1α expression was linked to shorter OS in the digestive tract, epithelial ovarian, breast, non-small cell lung, and clear cell renal cell carcinomas. Subgroup analysis by study region showed that HIF-1α expression was correlated with poor OS in Europeans and Asians, while an analysis by histologic subtypes found that HIF-1α expression was not associated with OS in squamous cell carcinoma. No relationship was found between HIF-2α expression and OS, DFS, PFS, or CSS. Conclusions: Targeting HIF-1α may be a useful therapeutic approach to improve survival for advanced cancer patients. Based on TSA, more randomized controlled trials are strongly suggested.
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Affiliation(s)
- Susu Han
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Road, 200071, People's Republic of China
| | - Tao Huang
- The Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Fenggang Hou
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, People's Republic of China
| | - Liting Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, People's Republic of China
| | - Xiyu Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, People's Republic of China
| | - Xing Wu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, People's Republic of China
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Ibrahim A, Vallières M, Woodruff H, Primakov S, Beheshti M, Keek S, Refaee T, Sanduleanu S, Walsh S, Morin O, Lambin P, Hustinx R, Mottaghy FM. Radiomics Analysis for Clinical Decision Support in Nuclear Medicine. Semin Nucl Med 2019; 49:438-449. [DOI: 10.1053/j.semnuclmed.2019.06.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Miller TA, Robinson KR, Li H, Seiwert TY, Haraf DJ, Lan L, Giger ML, Ginat DT. Prognostic value of pre-treatment CT texture analysis in combination with change in size of the primary tumor in response to induction chemotherapy for HPV-positive oropharyngeal squamous cell carcinoma. Quant Imaging Med Surg 2019; 9:399-408. [PMID: 31032187 DOI: 10.21037/qims.2019.03.08] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background To determine the additive value of quantitative radiomic texture features in predicting progression in human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) based on pre-treatment CT. Methods Retrospective analysis of a single-center cohort of adult patients enrolled in a response-adapted radiation volume de-escalation trial treated with induction chemotherapy. Texture analysis of HPV-positive OPSCC was performed via primary tumor site contouring on pre-treatment contrast-enhanced CT scans. Percent change in size of the tumor in response to induction chemotherapy based on RECIST 1.1 criteria and progression free survival were clinically determined for this cohort. Receiver operating characteristic (ROC) analysis was performed to compare the accuracy of percent change in tumor size after induction chemotherapy with a combination of change in tumor size and radiomic texture features for predicting tumor progression. Results Radiomic texture analysis of the primary tumors in 38 patients with OPSCC depicted on pre-treatment neck CT scans using skewness and entropy in combination with percent change in tumor size after induction chemotherapy yielded a statistically significant increase in accuracy for predicting tumor progression over change in tumor size alone, with an area under the curve of 0.80 versus 0.56 (one-tailed P=0.0087). Conclusions This pilot study suggests that disease progression in patients with HPV-positive OPSCC is more accurately predicted using a combination of texture features on pre-treatment CT scans, along with change in tumor size compared to change in tumor size alone and could therefore serve as a radiomic texture signature.
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Affiliation(s)
- Tamari A Miller
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Kayla R Robinson
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Hui Li
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Tanguy Y Seiwert
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Daniel J Haraf
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Li Lan
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Maryellen L Giger
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
| | - Daniel T Ginat
- 1Pritzker School of Medicine, 2Department of Radiology, 3Section of Hematology-Oncology, Department of Medicine, 4Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL 60637, USA
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Werner RA, Bundschuh RA, Higuchi T, Javadi MS, Rowe SP, Zsótér N, Kroiss M, Fassnacht M, Buck AK, Kreissl MC, Lapa C. Volumetric and texture analysis of pretherapeutic 18F-FDG PET can predict overall survival in medullary thyroid cancer patients treated with Vandetanib. Endocrine 2019; 63:293-300. [PMID: 30206772 PMCID: PMC6394453 DOI: 10.1007/s12020-018-1749-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE The metabolically most active lesion in 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) PET/CT can predict progression-free survival (PFS) in patients with medullary thyroid carcinoma (MTC) starting treatment with the tyrosine kinase inhibitor (TKI) vandetanib. However, this metric failed in overall survival (OS) prediction. In the present proof of concept study, we aimed to explore the prognostic value of intratumoral textural features (TF) as well as volumetric parameters (total lesion glycolysis, TLG) derived by pre-therapeutic 18F-FDG PET. METHODS Eighteen patients with progressive MTC underwent baseline 18F-FDG PET/CT prior to and 3 months after vandetanib initiation. By manual segmentation of the tumor burden at baseline and follow-up PET, intratumoral TF and TLG were computed. The ability of TLG, imaging-based TF, and clinical parameters (including age, tumor marker doubling times, prior therapies and RET (rearranged during transfection) mutational status) for prediction of both PFS and OS were evaluated. RESULTS The TF Complexity and the volumetric parameter TLG obtained at baseline prior to TKI initiation successfully differentiated between low- and high-risk patients. Complexity allocated 10/18 patients to the high-risk group with an OS of 3.3 y (vs. low-risk group, OS = 5.3 y, 8/18, AUC = 0.78, P = 0.03). Baseline TLG designated 11/18 patients to the high-risk group (OS = 3.5 y vs. low-risk group, OS = 5 y, 7/18, AUC = 0.83, P = 0.005). The Hazard Ratio for cancer-related death was 6.1 for Complexity (TLG, 9.5). Among investigated clinical parameters, the age at initiation of TKI treatment reached significance for PFS prediction (P = 0.02, OS, n.s.). CONCLUSIONS The TF Complexity and the volumetric parameter TLG are both independent parameters for OS prediction.
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Affiliation(s)
- Rudolf A Werner
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Ralph A Bundschuh
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Biomedical Imaging, National Cardiovascular and Cerebral Research Center, Suita, Japan
| | - Mehrbod S Javadi
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Steven P Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Matthias Kroiss
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
- Würzburger Schilddrüsenzentrum, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg, Wuerzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Wuerzburg, Wuerzburg, Germany
- Würzburger Schilddrüsenzentrum, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
- Comprehensive Heart Failure Center, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Michael C Kreissl
- Department of Nuclear Medicine, Hospital Augsburg, Augsburg, Germany
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Constantin Lapa
- Department of Nuclear Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
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Radiomics Analysis of PET and CT Components of PET/CT Imaging Integrated with Clinical Parameters: Application to Prognosis for Nasopharyngeal Carcinoma. Mol Imaging Biol 2019; 21:954-964. [DOI: 10.1007/s11307-018-01304-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Abstract
There are recent advances, namely, a standardized method for reporting therapy response (Hopkins criteria), a multicenter prospective cohort study with excellent negative predictive value of F-FDG PET/CT for N0 clinical neck, a phase III multicenter randomized controlled study establishing the value of a negative posttherapy F-FDG PET/CT for patient management, a phase II randomized controlled study demonstrating radiation dose reduction strategies for human papilloma virus-related disease, and Food and Drug Administration approval of nivolumab for treatment of recurrent head and neck squamous cell carcinoma.
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Fujima N, Hirata K, Shiga T, Li R, Yasuda K, Onimaru R, Tsuchiya K, Kano S, Mizumachi T, Homma A, Kudo K, Shirato H. Integrating quantitative morphological and intratumoural textural characteristics in FDG-PET for the prediction of prognosis in pharynx squamous cell carcinoma patients. Clin Radiol 2018; 73:1059.e1-1059.e8. [PMID: 30245069 DOI: 10.1016/j.crad.2018.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/24/2018] [Indexed: 12/15/2022]
Abstract
AIM To assess potential prognostic factors in pharynx squamous cell carcinoma (SCC) patients by quantitative morphological and intratumoural characteristics obtained by 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). MATERIALS AND METHODS The cases of 54 patients with pharynx SCC who underwent chemoradiation therapy were analysed retrospectively. Using their FDG-PET data, the quantitative morphological and intratumoural characteristics of 14 parameters were calculated. The progression-free survival (PFS) and overall survival (OS) information was obtained from patient medical records. Univariate and multivariate analyses were performed to assess the 14 quantitative parameters as well as the T-stage, N-stage, and tumour location data for their relation to PFS and OS. When an independent predictor was suggested in the multivariate analysis, the parameter was further assessed using the Kaplan-Meier method. RESULTS In the assessment of PFS, the univariate and multivariate analyses indicated the following as independent predictors: the texture parameter of homogeneity and the morphological parameter of sphericity. In the Kaplan-Meier analysis, the PFS rate was significantly improved in the patients who had both a higher value of homogeneity (p=0.01) and a higher value of sphericity (p=0.002). With the combined use of homogeneity and sphericity, the patients with different PFS rates could be divided more clearly. CONCLUSION The quantitative parameters of homogeneity and sphericity obtained by FDG-PET can be useful for the prediction of the PFS of pharynx SCC patients, especially when used in combination.
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Affiliation(s)
- N Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14 W5, Kita-Ku, Sapporo 0608638, Japan.
| | - K Hirata
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - T Shiga
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - R Li
- Department of Radiation Oncology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA 94305-5847, USA; The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, N15 W8, Kita-Ku, Sapporo 0608638, Japan
| | - K Yasuda
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, N15 W8, Kita-Ku, Sapporo 0608638, Japan; Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - R Onimaru
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - K Tsuchiya
- Department of Radiation Oncology, Otaru General Hospital, Wakamatsu1-1-1, Otaru 0478550, Japan
| | - S Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - T Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - A Homma
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
| | - K Kudo
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14 W5, Kita-Ku, Sapporo 0608638, Japan
| | - H Shirato
- The Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education, N15 W8, Kita-Ku, Sapporo 0608638, Japan; Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-Ku, Sapporo 0608638, Japan
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Heterogeneity analysis of 18F-FDG PET imaging in oncology: clinical indications and perspectives. Clin Transl Imaging 2018. [DOI: 10.1007/s40336-018-0299-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Lee JW, Lee SM. Radiomics in Oncological PET/CT: Clinical Applications. Nucl Med Mol Imaging 2018; 52:170-189. [PMID: 29942396 PMCID: PMC5995782 DOI: 10.1007/s13139-017-0500-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/22/2017] [Accepted: 09/29/2017] [Indexed: 12/11/2022] Open
Abstract
18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is widely used for staging, evaluating treatment response, and predicting prognosis in malignant diseases. FDG uptake and volumetric PET parameters such as metabolic tumor volume have been used and are still used as conventional PET parameters to assess biological characteristics of tumors. However, in recent years, additional features derived from PET images by computational processing have been found to reflect intratumoral heterogeneity, which is related to biological tumor features, and to provide additional predictive and prognostic information, which leads to the concept of radiomics. In this review, we focus on recent clinical studies of malignant diseases that investigated intratumoral heterogeneity on PET/CT, and we discuss its clinical role in various cancers.
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Affiliation(s)
- Jeong Won Lee
- Department of Nuclear Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, 25, Simgok-ro 100 Gil 25, Seo-gu, Incheon, 22711 South Korea
- Institute for Integrative Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Sang Mi Lee
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
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Radiomics in Nuclear Medicine Applied to Radiation Therapy: Methods, Pitfalls, and Challenges. Int J Radiat Oncol Biol Phys 2018; 102:1117-1142. [PMID: 30064704 DOI: 10.1016/j.ijrobp.2018.05.022] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/27/2018] [Accepted: 05/02/2018] [Indexed: 02/06/2023]
Abstract
Radiomics is a recent area of research in precision medicine and is based on the extraction of a large variety of features from medical images. In the field of radiation oncology, comprehensive image analysis is crucial to personalization of treatments. A better characterization of local heterogeneity and the shape of the tumor, depicting individual cancer aggressiveness, could guide dose planning and suggest volumes in which a higher dose is needed for better tumor control. In addition, noninvasive imaging features that could predict treatment outcome from baseline scans could help the radiation oncologist to determine the best treatment strategies and to stratify patients as at low risk or high risk of recurrence. Nuclear medicine molecular imaging reflects information regarding biological processes in the tumor thanks to a wide range of radiotracers. Many studies involving 18F-fluorodeoxyglucose positron emission tomography suggest an added value of radiomics compared with the use of conventional PET metrics such as standardized uptake value for both tumor diagnosis and prediction of recurrence or treatment outcome. However, these promising results should not hide technical difficulties that still currently prevent the approach from being widely studied or clinically used. These difficulties mostly pertain to the variability of the imaging features as a function of the acquisition device and protocol, the robustness of the models with respect to that variability, and the interpretation of the radiomic models. Addressing the impact of the variability in acquisition and reconstruction protocols is needed, as is harmonizing the radiomic feature calculation methods, to ensure the reproducibility of studies in a multicenter context and their implementation in a clinical workflow. In this review, we explain the potential impact of positron emission tomography radiomics for radiation therapy and underline the various aspects that need to be carefully addressed to make the most of this promising approach.
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Associations of Tumor PD-1 Ligands, Immunohistochemical Studies, and Textural Features in 18F-FDG PET in Squamous Cell Carcinoma of the Head and Neck. Sci Rep 2018; 8:105. [PMID: 29311707 PMCID: PMC5758832 DOI: 10.1038/s41598-017-18489-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/12/2017] [Indexed: 01/22/2023] Open
Abstract
To know tumor PD-L1 expression through IHC or the FDG-PET related radiomics, we investigated the association between programmed cell death protein 1 ligand (PD-L1) expression and immunohistochemical (IHC) biomarkers or textural features of 18F-fluoro-2-deoxdeoxyglucose positron emission tomography (18F-FDG PET) in 53 oropharyngeal or hypopharyngeal cancer patients who were ready to undergo radiotherapy-based treatment. Differences in textural features or biomarkers between tumors with and without PD-L1 expression were tested using a Mann–Whitney U test. The predicted values for PD-L1 expression were examined using logistic regression analysis. The mean percentages of tumor PD-L1 expression were 6.2 ± 13.5. Eighteen tumors had PD-L1 expression ≥5%, whereas 30 tumors ≥1%. Using a 5% cutoff, the p16 staining percentage and the textural index of correlation were two factors associated with PD-L1 expression. The odds ratios (ORs) were 17.00 (p = 0.028) and 0.009 (p = 0.015), respectively. When dichotomizing PD-L1 at 1%, the p16 and Ki-67 staining percentages were two predictors for PD-L1 expression with ORs of 11.41 (p = 0.035) and 757.77 (p = 0.045). p16 and Ki-67 staining percentages and several PET/CT-derived textural features can provide supplemental information to determine tumor PD-L1 expression in HNCs.
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Schillaci O, Urbano N. Personalized medicine: a new option for nuclear medicine and molecular imaging in the third millennium. Eur J Nucl Med Mol Imaging 2017; 44:563-566. [PMID: 28083691 DOI: 10.1007/s00259-017-3616-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Viale Mazzini 121, 00195, Rome, Italy.
- IRCCS Neuromed, Pozzilli, Italy.
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