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Yang F, Feng Y, Sun P, Traverso A, Dekker A, Zhang B, Huang Z, Wang Z, Yan D. Preoperative prediction of high-grade osteosarcoma response to neoadjuvant therapy based on a plain CT radiomics model: A dual-center study. J Bone Oncol 2024; 47:100614. [PMID: 38975332 PMCID: PMC11225658 DOI: 10.1016/j.jbo.2024.100614] [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: 01/25/2024] [Revised: 05/05/2024] [Accepted: 06/01/2024] [Indexed: 07/09/2024] Open
Abstract
Objective To develop a model combining clinical and radiomics features from CT scans for a preoperative noninvasive evaluation of Huvos grading of neoadjuvant chemotherapy in patients with HOS. Methods 183 patients from center A and 42 from center B were categorized into training and validation sets. Features derived from radiomics were obtained from unenhanced CT scans.Following dimensionality reduction, the most optimal features were selected and utilized in creating a radiomics model through logistic regression analysis. Integrating clinical features, a composite clinical radiomics model was developed, and a nomogram was constructed. Predictive performance of the model was evaluated using ROC curves and calibration curves. Additionally, decision curve analysis was conducted to assess practical utility of nomogram in clinical settings. Results LASSO LR analysis was performed, and finally, three selected image omics features were obtained.Radiomics model yielded AUC values with a good diagnostic effect for both patient sets (AUCs: 0.69 and 0.68, respectively). Clinical models (including sex, age, pre-chemotherapy ALP and LDH levels, new lung metastases within 1 year after surgery, and incidence) performed well in terms of Huvos grade prediction, with an AUC of 0.74 for training set. The AUC for independent validation set stood at 0.70. Notably, the amalgamation of radiomics and clinical features exhibited commendable predictive prowess in training set, registering an AUC of 0.78. This robust performance was subsequently validated in the independent validation set, where the AUC remained high at 0.75. Calibration curves of nomogram showed that the predictions were in good agreement with actual observations. Conclusion Combined model can be used for Huvos grading in patients with HOS after preoperative chemotherapy, which is helpful for adjuvant treatment decisions.
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Affiliation(s)
- Fan Yang
- Department of Radiation, Beijing Jishuitan Hospital,Capital Medical University, Beijing 100035, China
| | - Ying Feng
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Pengfei Sun
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Alberto Traverso
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (Maastro), GROW-School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bin Zhang
- Department of Radiation, Peking University Shougang Hospital, Beijing 100144, China
| | - Zhen Huang
- Department of Bone Oncology, Beijing Jishuitan Hospital,Capital Medical University, Beijing 100035, China
| | - Zhixiang Wang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Dong Yan
- Department of Radiation, Beijing Jishuitan Hospital,Capital Medical University, Beijing 100035, China
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2
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Zhou S, Liu Q, Fu Y, Du L, Bao Q, Zhang Z, Xu Z, Yan F, Li M, Liu R, Qin L, Zhang W. CT-derived Radiomics Predicts the Efficacy of Tyrosine Kinase Inhibitors in Osteosarcoma Patients with Pulmonary Metastasis. Transl Oncol 2024; 45:101993. [PMID: 38743988 PMCID: PMC11109890 DOI: 10.1016/j.tranon.2024.101993] [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: 01/08/2024] [Revised: 04/02/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND To construct and validate the CT-based radiomics model for predicting the tyrosine kinase inhibitors (TKIs) effects in osteosarcoma (OS) patients with pulmonary metastasis. METHODS OS patients with pulmonary metastasis treated with TKIs were randomly separated into training and testing cohorts (2:1 ratio). Radiomic features were extracted from the baseline unenhanced chest CT images. The random survival forest (RSF) and Kaplan-Meier survival analyses were performed to construct and evaluate radiomics signatures (R-model-derived). The univariant and multivariant Cox regression analyses were conducted to establish clinical (C-model) and combined models (RC-model). The discrimination abilities, goodness of fit and clinical benefits of the three models were assessed and validated in both training and testing cohorts. RESULTS A total of 90 patients, 57 men and 33 women, with a mean age of 18 years and median progression-free survival (PFS) of 7.2 months, were enrolled. The R-model was developed with nine radiomic features and demonstrated significant predictive and prognostic values. In both training and testing cohorts, the time-dependent area under the receiver operating characteristic curves (AUC) of the R-model and RC-model exhibited obvious superiority over C-model. The calibration and decision curve analysis (DCA) curves indicated that the accuracy of the R-model was comparable to RC-model, which exhibited significantly better performance than C-model. CONCLUSIONS The R-model showed promising potential as a predictor for TKI responses in OS patients with pulmonary metastasis. It can potentially identify pulmonary metastatic OS patients most likely to benefit from TKIs treatment and help guide optimized clinical decisions.
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Affiliation(s)
- Shanshui Zhou
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qi Liu
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yucheng Fu
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lianjun Du
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Qiyuan Bao
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhusheng Zhang
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Zhihan Xu
- Siemens Healthineers CT Collaboration, Shanghai, PR China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Meng Li
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Ruixuan Liu
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Le Qin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weibin Zhang
- Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Kalisvaart GM, Evenhuis RE, Grootjans W, Van Den Berghe T, Callens M, Bovée JVMG, Creytens D, Gelderblom H, Speetjens FM, Lapeire L, Sys G, Fiocco M, Verstraete KL, van de Sande MAJ, Bloem JL. Relative Wash-In Rate in Dynamic Contrast-Enhanced Magnetic Resonance Imaging as a New Prognostic Biomarker for Event-Free Survival in 82 Patients with Osteosarcoma: A Multicenter Study. Cancers (Basel) 2024; 16:1954. [PMID: 38893075 PMCID: PMC11171179 DOI: 10.3390/cancers16111954] [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: 05/02/2024] [Revised: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The decreased perfusion of osteosarcoma in dynamic contrast-enhanced (DCE) MRI, reflecting a good histological response to neoadjuvant chemotherapy, has been described. PURPOSE In this study, we aim to explore the potential of the relative wash-in rate as a prognostic factor for event-free survival (EFS). METHODS Skeletal high-grade osteosarcoma patients, treated in two tertiary referral centers between 2005 and 2022, were retrospectively included. The relative wash-in rate (rWIR) was determined with DCE-MRI before, after, or during the second cycle of chemotherapy (pre-resection). A previously determined cut-off was used to categorize patients, where rWIR < 2.3 was considered poor and rWIR ≥ 2.3 a good radiological response. EFS was defined as the time from resection to the first event: local recurrence, new metastases, or tumor-related death. EFS was estimated using Kaplan-Meier's methodology. Multivariate Cox proportional hazard model was used to estimate the effect of histological response and rWIR on EFS, adjusted for traditional prognostic factors. RESULTS Eighty-two patients (median age: 17 years; IQR: 14-28) were included. The median follow-up duration was 11.8 years (95% CI: 11.0-12.7). During follow-up, 33 events occurred. Poor histological response was not significantly associated with EFS (HR: 1.8; 95% CI: 0.9-3.8), whereas a poor radiological response was associated with a worse EFS (HR: 2.4; 95% CI: 1.1-5.0). In a subpopulation without initial metastases, the binary assessment of rWIR approached statistical significance (HR: 2.3; 95% CI: 1.0-5.2), whereas its continuous evaluation demonstrated a significant association between higher rWIR and improved EFS (HR: 0.7; 95% CI: 0.5-0.9), underlining the effect of response to chemotherapy. The 2- and 5-year EFS for patients with a rWIR ≥ 2.3 were 85% and 75% versus 55% and 50% for patients with a rWIR < 2.3. CONCLUSION The predicted poor chemo response with MRI (rWIR < 2.3) is associated with shorter EFS even when adjusted for known clinical covariates and shows similar results to histological response evaluation. rWIR is a potential tool for future response-based individualized healthcare in osteosarcoma patients before surgical resection.
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Affiliation(s)
- Gijsbert M. Kalisvaart
- Department of Radiology, Leiden University Medical Center, 2333 Leiden, The Netherlands; (G.M.K.)
| | - Richard E. Evenhuis
- Department of Orthopedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, The Netherlands
| | - Willem Grootjans
- Department of Radiology, Leiden University Medical Center, 2333 Leiden, The Netherlands; (G.M.K.)
| | | | - Martijn Callens
- Department of Radiology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Judith V. M. G. Bovée
- Department of Pathology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - David Creytens
- Department of Pathology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Frank M. Speetjens
- Department of Medical Oncology, Leiden University Medical Center, 2333 Leiden, The Netherlands
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Gwen Sys
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Marta Fiocco
- Department of Biomedical Science, Section Medical Statistics, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Center for Pediatric Oncology, Princess Maxima Center, 3584 Utrecht, The Netherlands
- Mathematical Institute, Leiden University, 2300 Leiden, The Netherlands
| | | | - Michiel A. J. van de Sande
- Department of Orthopedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 Leiden, The Netherlands
- Center for Pediatric Oncology, Princess Maxima Center, 3584 Utrecht, The Netherlands
| | - Johan L. Bloem
- Department of Radiology, Leiden University Medical Center, 2333 Leiden, The Netherlands; (G.M.K.)
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4
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Su Q, Wang N, Wang B, Wang Y, Dai Z, Zhao X, Li X, Li Q, Yang G, Nie P. Ct-based intratumoral and peritumoral radiomics for predicting prognosis in osteosarcoma: A multicenter study. Eur J Radiol 2024; 172:111350. [PMID: 38309216 DOI: 10.1016/j.ejrad.2024.111350] [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: 08/13/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
PURPOSE To evaluate the performance of CT-based intratumoral, peritumoral and combined radiomics signatures in predicting prognosis in patients with osteosarcoma. METHODS The data of 202 patients (training cohort:102, testing cohort:100) with osteosarcoma admitted to the two hospitals from August 2008 to February 2022 were retrospectively analyzed. Progression free survival (PFS) and overall survival (OS) were used as the end points. The radiomics features were extracted from CT images, three radiomics signatures(RSintratumoral, RSperitumoral, RScombined)were constructed based on intratumoral, peritumoral and combined radiomics features, respectively, and the radiomics score (Rad-score) were calculated. Kaplan-Meier survival analysis was used to evaluate the relationship between the Rad-score with PFS and OS, the Harrell's concordance index (C-index) was used to evaluate the predictive performance of the radiomics signatures. RESULTS Finally, 8, 6, and 21 features were selected for the establishment of RSintratumoral, RSperitumoral, and RScombined, respectively. Kaplan-Meier survival analysis confirmed that the Rad-scores of the three RSs were significantly correlated with the PFS and OS of patients with osteosarcoma. Among the three radiomics signatures, RScombined had better predictive performance, the C-index of PSF prediction was 0.833 in the training cohort and 0.814 in the testing cohort, the C-index of OS prediction was 0.796 in the training cohort and 0.764 in the testing cohort. CONCLUSIONS CT-based intratumoral, peritumoral and combined radiomics signatures can predict the prognosis of patients with osteosarcoma, which may assist in individualized treatment and improving the prognosis of osteosarcoma patients.
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Affiliation(s)
- Qiushi Su
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Ning Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Bingyan Wang
- Department of Ultrasound, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | | | - Zhengjun Dai
- Scientific Research Department, Huiying Medical Technology Co., Ltd, Beijing, China
| | - Xia Zhao
- Department of Radiology, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiaoli Li
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Qiyuan Li
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Guangjie Yang
- Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| | - Pei Nie
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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Brandenberger D, White LM. Radiomics in Musculoskeletal Tumors. Semin Musculoskelet Radiol 2024; 28:49-61. [PMID: 38330970 DOI: 10.1055/s-0043-1776428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Sarcomas are heterogeneous rare tumors predominantly affecting the musculoskeletal (MSK) system. Due to significant variations in their natural history and variable response to conventional treatments, the discovery of novel diagnostic and prognostic biomarkers to guide therapeutic decision-making is an active and ongoing field of research. As new cellular, molecular, and metabolic biomarkers continue to be discovered, quantitative radiologic imaging is becoming increasingly important in sarcoma management. Radiomics offers the potential for discovering novel imaging diagnostic and predictive biomarkers using standard-of-care medical imaging. In this review, we detail the core concepts of radiomics and the application of radiomics to date in MSK sarcoma research. Also described are specific challenges related to radiomic studies, as well as viewpoints on clinical adoption and future perspectives in the field.
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Affiliation(s)
- Daniel Brandenberger
- Department of Medical Imaging, Musculoskeletal Imaging, University of Toronto, Toronto, Ontario, Canada
- Institut für Radiologie und Nuklearmedizin, Kantonsspital Baselland, Liestal, Switzerland
- Toronto Joint Department of Medical Imaging, University Health Network, Sinai Health System, and Women's College Hospital, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Lawrence M White
- Department of Medical Imaging, Musculoskeletal Imaging, University of Toronto, Toronto, Ontario, Canada
- Toronto Joint Department of Medical Imaging, University Health Network, Sinai Health System, and Women's College Hospital, Mount Sinai Hospital, Toronto, Ontario, Canada
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6
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Zhang X, Peng J, Ji G, Li T, Li B, Xiong H. Research status and progress of radiomics in bone and soft tissue tumors: A review. Medicine (Baltimore) 2023; 102:e36196. [PMID: 38013345 PMCID: PMC10681559 DOI: 10.1097/md.0000000000036198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023] Open
Abstract
Bone and soft tissue tumors are diverse, accompanying by complex histological components and significantly divergent biological behaviors. It is a challenge to address the demand for qualitative imaging as traditional imaging is restricted to the detection of anatomical structures and aberrant signals. With the improvement of digitalization in hospitals and medical centers, the introduction of electronic medical records and easier access to large amounts of information coupled with the improved computational power, traditional medicine has evolved into the combination of human brain, minimal data, and artificial intelligence. Scholars are committed to mining deeper levels of imaging data, and radiomics is worthy of promotion. Radiomics extracts subvisual quantitative features, analyzes them based on medical images, and quantifies tumor heterogeneity by outlining the region of interest and modeling. Two observers separately examined PubMed, Web of Science and CNKI to find existing studies, case reports, and clinical guidelines about research status and progress of radiomics in bone and soft tissue tumors from January 2010 to February 2023. When evaluating the literature, factors such as patient age, medical history, and severity of the condition will be considered. This narrative review summarizes the application and progress of radiomics in bone and soft tissue tumors.
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Affiliation(s)
- Xiaohan Zhang
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Jie Peng
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Guanghai Ji
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Tian Li
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Bo Li
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Hao Xiong
- Department of Radiology, The First Affiliated Hospital of Yangtze University, Jingzhou, China
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7
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Meng Y, Yang Y, Hu M, Zhang Z, Zhou X. Artificial intelligence-based radiomics in bone tumors: Technical advances and clinical application. Semin Cancer Biol 2023; 95:75-87. [PMID: 37499847 DOI: 10.1016/j.semcancer.2023.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/29/2023]
Abstract
Radiomics is the extraction of predefined mathematic features from medical images for predicting variables of clinical interest. Recent research has demonstrated that radiomics can be processed by artificial intelligence algorithms to reveal complex patterns and trends for diagnosis, and prediction of prognosis and response to treatment modalities in various types of cancer. Artificial intelligence tools can utilize radiological images to solve next-generation issues in clinical decision making. Bone tumors can be classified as primary and secondary (metastatic) tumors. Osteosarcoma, Ewing sarcoma, and chondrosarcoma are the dominating primary tumors of bone. The development of bone tumor model systems and relevant research, and the assessment of novel treatment methods are ongoing to improve clinical outcomes, notably for patients with metastases. Artificial intelligence and radiomics have been utilized in almost full spectrum of clinical care of bone tumors. Radiomics models have achieved excellent performance in the diagnosis and grading of bone tumors. Furthermore, the models enable to predict overall survival, metastases, and recurrence. Radiomics features have exhibited promise in assisting therapeutic planning and evaluation, especially neoadjuvant chemotherapy. This review provides an overview of the evolution and opportunities for artificial intelligence in imaging, with a focus on hand-crafted features and deep learning-based radiomics approaches. We summarize the current application of artificial intelligence-based radiomics both in primary and metastatic bone tumors, and discuss the limitations and future opportunities of artificial intelligence-based radiomics in this field. In the era of personalized medicine, our in-depth understanding of emerging artificial intelligence-based radiomics approaches will bring innovative solutions to bone tumors and achieve clinical application.
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Affiliation(s)
- Yichen Meng
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, PR China
| | - Yue Yang
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, PR China
| | - Miao Hu
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, PR China
| | - Zheng Zhang
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, PR China.
| | - Xuhui Zhou
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, PR China.
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8
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White LM, Atinga A, Naraghi AM, Lajkosz K, Wunder JS, Ferguson P, Tsoi K, Griffin A, Haider M. T2-weighted MRI radiomics in high-grade intramedullary osteosarcoma: predictive accuracy in assessing histologic response to chemotherapy, overall survival, and disease-free survival. Skeletal Radiol 2023; 52:553-564. [PMID: 35778618 DOI: 10.1007/s00256-022-04098-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To analyze radiomic features obtained from pre-treatment T2-weighted MRI acquisitions in patients with histologically proven intramedullary high-grade osteosarcomas and assess the accuracy of radiomic modelling as predictive biomarker of tumor necrosis following neoadjuvant chemotherapy (NAC), overall survival (OS), and disease-free survival (DFS). MATERIALS AND METHODS Pre-treatment MRI exams in 105 consecutive patients who underwent NAC and resection of high-grade intramedullary osteosarcoma were evaluated. Histologic necrosis following NAC, and clinical outcome-survival data was collected for each case. Radiomic features were extracted from segmentations performed by two readers, with poorly reproducible features excluded from further analysis. Cox proportional hazard model and Spearman correlation with multivariable modelling were used for assessing relationships of radiomics features with OS, DFS, and histologic tumor necrosis. RESULTS Study included 74 males, 31 females (mean 32.5yrs, range 15-77 years). Histologic assessment of tumor necrosis following NAC was available in 104 cases, with good response (≥ 90% necrosis) in 41, and poor response in 63. Fifty-three of 105 patients were alive at follow-up (median 40 months, range: 2-213 months). Median OS was 89 months. Excluding 14 patients with metastases at presentation, median DFS was 19 months. Eleven radiomics features were employed in final radiomics model predicting histologic tumor necrosis (mean AUC 0.708 ± 0.046). Thirteen radiomic features were used in model predicting OS (mean concordance index 0.741 ± 0.011), and 12 features retained in predicting DFS (mean concordance index 0.745 ± 0.010). CONCLUSIONS T2-weighted MRI radiomic models demonstrate promising results as potential prognostic biomarkers of prospective tumor response to neoadjuvant chemotherapy and prediction of clinical outcomes in conventional osteosarcoma.
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Affiliation(s)
- Lawrence M White
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada. .,Joint Department of Medical Imaging, Mount Sinai Hospital, University Health Network and Women's College Hospital, Rm 562-A, 600 University Ave, Toronto, ON, M5G 1X5, Canada. .,Toronto Sarcoma Program, Mount Sinai Hospital, Toronto, ON, Canada.
| | - Angela Atinga
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ali M Naraghi
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Joint Department of Medical Imaging, Mount Sinai Hospital, University Health Network and Women's College Hospital, Rm 562-A, 600 University Ave, Toronto, ON, M5G 1X5, Canada.,Toronto Sarcoma Program, Mount Sinai Hospital, Toronto, ON, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jay S Wunder
- Toronto Sarcoma Program, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Surgery, Division of Orthopedic Surgery, Musculoskeletal Oncology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Peter Ferguson
- Toronto Sarcoma Program, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Surgery, Division of Orthopedic Surgery, Musculoskeletal Oncology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Kim Tsoi
- Toronto Sarcoma Program, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Surgery, Division of Orthopedic Surgery, Musculoskeletal Oncology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Anthony Griffin
- Department of Surgery, Division of Orthopedic Surgery, Musculoskeletal Oncology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Masoom Haider
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Joint Department of Medical Imaging, Mount Sinai Hospital, University Health Network and Women's College Hospital, Rm 562-A, 600 University Ave, Toronto, ON, M5G 1X5, Canada
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9
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Ma Y, Zheng S, Xu M, Chen C, He H. Establishing and Validating an Aging-Related Prognostic Signature in Osteosarcoma. Stem Cells Int 2023; 2023:6245160. [PMID: 37964984 PMCID: PMC10643040 DOI: 10.1155/2023/6245160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/22/2022] [Accepted: 09/30/2022] [Indexed: 11/16/2023] Open
Abstract
Aging is an inevitable process that biological changes accumulate with time and results in increased susceptibility to different tumors. But currently, aging-related genes (ARGs) in osteosarcoma were not clear. We investigated the potential prognostic role of ARGs and established an ARG-based prognostic signature for osteosarcoma. The transcriptome data and corresponding clinicopathological information of patients with osteosarcoma were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Molecular subtypes were generated based on prognosis-related ARGs obtained from univariate Cox analysis. With ARGs, a risk signature was built by univariate, least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression analyses. Differences in clinicopathological features, immune infiltration, immune checkpoints, responsiveness to immunotherapy and chemotherapy, and biological pathways were assessed according to molecular subtypes and the risk signature. Based on risk signature and clinicopathological variables, a nomogram was established and validated. Three molecular subtypes with distinct clinical outcomes were classified based on 36 prognostic ARGs for osteosarcoma. A nine-ARG-based signature in the TCGA cohort, including BMP8A, CORT, SLC17A9, VEGFA, GAL, SSX1, RASGRP2, SDC3, and EVI2B, has been created and developed and could well perform patient stratification into the high- and low-risk groups. There were significant differences in clinicopathological features, immune checkpoints and infiltration, responsiveness to immunotherapy and chemotherapy, cancer stem cell, and biological pathways among the molecular subtypes. The risk signature and metastatic status were identified as independent prognostic factors for osteosarcoma. A nomogram combining ARG-based risk signature and metastatic status was established, showing great prediction accuracy and clinical benefit for osteosarcoma OS. We characterized three ARG-based molecular subtypes with distinct characteristics and built an ARG-based risk signature for osteosarcoma prognosis, which could facilitate prognosis prediction and making personalized treatment in osteosarcoma.
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Affiliation(s)
- Yibo Ma
- Graduate School of Dalian Medical University, Dalian Medical University, Dalian, China 116044
| | - Shuo Zheng
- The Second Ward of Department of Orthopedics, The Second Hospital of Dalian Medical University, Dalian, China 116000
| | - Mingjun Xu
- The Second Hospital of Dalian Medical University, Dalian Medical University, Dalian, China 116000
| | - Changjian Chen
- The First Ward of Department of Orthopedics, The Second Hospital of Dalian Medical University, Dalian, China 116000
| | - Hongtao He
- The Third Ward of Department of Orthopedics, The Second Hospital of Dalian Medical University, Dalian, China 116000
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10
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A Computed Tomography Radiomics Nomogram in Differentiating Chordoma From Giant Cell Tumor in the Axial Skeleton. J Comput Assist Tomogr 2023; 47:453-459. [PMID: 36728104 DOI: 10.1097/rct.0000000000001436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of the study is to develop and validate a computed tomography (CT) radiomics nomogram for preoperatively differentiating chordoma from giant cell tumor (GCT) in the axial skeleton. METHODS Seventy-three chordomas and 38 GCTs in axial skeleton were retrospectively included and were divided into a training cohort (n = 63) and a test cohort (n = 48). The radiomics features were extracted from CT images. A radiomics signature was developed by using the least absolute shrinkage and selection operator model, and a radiomics score (Rad-score) was acquired. By combining the Rad-score with independent clinical risk factors using multivariate logistic regression model, a radiomics nomogram was established. Calibration and receiver operator characteristic curves were used to assess the performance of the nomogram. RESULTS Five features were selected to construct the radiomics signature. The radiomics signature showed favorable discrimination in the training cohort (area under the curve [AUC], 0.860; 95% confidence interval [CI], 0.760-0.960) and the test cohort (AUC, 0.830; 95% CI, 0.710-0.950). Age and location were the independent clinical factors. The radiomics nomogram combining the Rad-score with independent clinical factors showed good discrimination capability in the training cohort (AUC, 0.930; 95% CI, 0.880-0.990) and the test cohort (AUC, 0.980; 95% CI, 0.940-1.000) and outperformed the radiomics signature (z = 2.768, P = 0.006) in the test cohort. CONCLUSIONS The CT radiomics nomogram shows good predictive efficacy in differentiating chordoma from GCT in the axial skeleton, which might facilitate clinical decision making.
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Ling Z, Li X, Wu G, Fadoul H. Radiomics of CTA is feasible in identifying muscle ischemia. Acta Radiol 2022; 64:1469-1475. [PMID: 36050936 DOI: 10.1177/02841851221119884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advanced models based on computed tomography angiography (CTA) radiomics features in discriminating muscle ischemia from normal condition are lacking. PURPOSE To investigate the feasibility of radiomics of CTA in discriminating ischemic muscle from normal muscle. MATERIAL AND METHODS A total of 102 patients (51 ischemia and 51 non-ischemia) were analyzed using a CTA radiomics method. The radiomics features of muscle were compared between ischemic and normal cases. The maximum relevance minimum redundancy (mRMR) algorithm and least absolute shrinkage and selection operator (LASSO) logistic regression model were used. The receiver operating characteristic (ROC) curve was used to determine the performance of radiomics signature. RESULTS Thirty-nine CTA radiomics features were significantly different between the two groups (P < 0.05). By LASSO, six features were used to construct a model. The signature area under the curve was 0.92 and 0.91 in the training and validation cohorts, respectively. The sensitivity and specificity of the signature were 92% and 86% for the training cohort, and 80% and 94% for the validation cohort, respectively. CONCLUSION CTA radiomics signature is useful in identifying ischemic muscle in selected patients.
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Affiliation(s)
- Zhiyu Ling
- Department of Radiology, The first People's Hospital of Yongkang, Yongkang, Zhejiang, PR China
| | - Xiaoming Li
- Department of Radiology, 66375Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
| | - Gang Wu
- Department of Radiology, 66375Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
| | - Hissein Fadoul
- Department of Radiology, 66375Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
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12
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Zhong J, Hu Y, Zhang G, Xing Y, Ding D, Ge X, Pan Z, Yang Q, Yin Q, Zhang H, Zhang H, Yao W. An updated systematic review of radiomics in osteosarcoma: utilizing CLAIM to adapt the increasing trend of deep learning application in radiomics. Insights Imaging 2022; 13:138. [PMID: 35986808 PMCID: PMC9392674 DOI: 10.1186/s13244-022-01277-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To update the systematic review of radiomics in osteosarcoma.
Methods
PubMed, Embase, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were searched to identify articles on osteosarcoma radiomics until May 15, 2022. The studies were assessed by Radiomics Quality Score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement, Checklist for Artificial Intelligence in Medical Imaging (CLAIM), and modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The evidence supporting radiomics application for osteosarcoma was rated according to meta-analysis results.
Results
Twenty-nine articles were included. The average of the ideal percentage of RQS, the TRIPOD adherence rate and the CLAIM adherence rate were 29.2%, 59.2%, and 63.7%, respectively. RQS identified a radiomics-specific issue of phantom study. TRIPOD addressed deficiency in blindness of assessment. CLAIM and TRIPOD both pointed out shortness in missing data handling and sample size or power calculation. CLAIM identified extra disadvantages in data de-identification and failure analysis. External validation and open science were emphasized by all the above three tools. The risk of bias and applicability concerns were mainly related to the index test. The meta-analysis of radiomics predicting neoadjuvant chemotherapy response by MRI presented a diagnostic odds ratio (95% confidence interval) of 28.83 (10.27–80.95) on testing datasets and was rated as weak evidence.
Conclusions
The quality of osteosarcoma radiomics studies is insufficient. More investigation is needed before using radiomics to optimize osteosarcoma treatment. CLAIM is recommended to guide the design and reporting of radiomics research.
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Zheng X, Xu S, Wu J. Cervical Cancer Imaging Features Associated With ADRB1 as a Risk Factor for Cerebral Neurovascular Metastases. Front Neurol 2022; 13:905761. [PMID: 35903112 PMCID: PMC9315067 DOI: 10.3389/fneur.2022.905761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Bioinformatics tools are used to create a clinical prediction model for cervical cancer metastasis and to investigate the neurovascular-related genes that are involved in brain metastasis of cervical cancer. One hundred eighteen patients with cervical cancer were divided into two groups based on the presence or absence of metastases, and the clinical data and imaging findings of the two groups were compared retrospectively. The nomogram-based model was successfully constructed by taking into account four clinical characteristics (age, stage, N, and T) as well as one imaging characteristic (original_glszm_GrayLevelVariance Rad-score). In patients with cervical cancer, headaches and vomiting were more often reported in the brain metastasis group than in the other metastasis groups. According to the TCGA data, mRNA differential gene expression analysis of patients with cervical cancer revealed an increase in the expression of neurovascular-related gene Adrenoceptor Beta 1 (ADRB1) in the brain metastasis group. An analysis of the correlation between imaging features and ADRB1 expression revealed that ADRB1 expression was significantly higher in the low Rad-score group compared with the high Rad-score group (P = 0.025). Therefore, ADRB1 expression in cervical cancer was correlated with imaging features and was associated as a risk factor for cerebral neurovascular metastases. This study developed a nomogram prediction model for cervical cancer metastasis using age, stage, N, T and original_glszm_GrayLevelVariance. As a risk factor associated with the development of cerebral neurovascular metastases of cervical cancer, ADRB1 expression was significantly higher in brain metastases from cervical cancer.
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Affiliation(s)
- Xingju Zheng
- Department of Radiology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Shilin Xu
- Department of Oncology, Xichang People's Hospital, Liangshan High-Tech Tumor Hospital, Xichang, China
| | - JiaYing Wu
- Department of Gynaecology and Obstetrics, Zhejiang Xinda Hospital, Huzhou, China
- *Correspondence: JiaYing Wu
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Rethinking U-Net from an Attention Perspective with Transformers for Osteosarcoma MRI Image Segmentation. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:7973404. [PMID: 35707196 PMCID: PMC9192230 DOI: 10.1155/2022/7973404] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/24/2022] [Accepted: 04/28/2022] [Indexed: 12/17/2022]
Abstract
Osteosarcoma is one of the most common primary malignancies of bone in the pediatric and adolescent populations. The morphology and size of osteosarcoma MRI images often show great variability and randomness with different patients. In developing countries, with large populations and lack of medical resources, it is difficult to effectively address the difficulties of early diagnosis of osteosarcoma with limited physician manpower alone. In addition, with the proposal of precision medicine, existing MRI image segmentation models for osteosarcoma face the challenges of insufficient segmentation accuracy and high resource consumption. Inspired by transformer's self-attention mechanism, this paper proposes a lightweight osteosarcoma image segmentation architecture, UATransNet, by adding a multilevel guided self-aware attention module (MGAM) to the encoder-decoder architecture of U-Net. We successively perform dataset classification optimization and remove MRI image irrelevant background. Then, UATransNet is designed with transformer self-attention component (TSAC) and global context aggregation component (GCAC) at the bottom of the encoder-decoder architecture to perform integration of local features and global dependencies and aggregation of contexts to learned features. In addition, we apply dense residual learning to the convolution module and combined with multiscale jump connections, to improve the feature extraction capability. In this paper, we experimentally evaluate more than 80,000 osteosarcoma MRI images and show that our UATransNet yields more accurate segmentation performance. The IOU and DSC values of osteosarcoma are 0.922 ± 0.03 and 0.921 ± 0.04, respectively, and provide intuitive and accurate efficient decision information support for physicians.
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15
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Wu Z, Bian T, Dong C, Duan S, Fei H, Hao D, Xu W. Spinal MRI-Based Radiomics Analysis to Predict Treatment Response in Multiple Myeloma. J Comput Assist Tomogr 2022; 46:447-454. [PMID: 35405690 DOI: 10.1097/rct.0000000000001298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to explore the clinical utility of spinal magnetic resonance imaging-based radiomics to predict treatment response (TR) in patients with multiple myeloma (MM). METHODS A total of 123 MM patients (85 in the training cohort and 38 in the test cohort) with complete response (CR) (n = 40) or non-CR (n = 83) were retrospectively enrolled in the study. Key feature selection and data dimension reduction were performed using the least absolute shrinkage and selection operator regression. A nomogram was built by combining radiomic signatures and independent clinical risk factors. The prediction performance of the nomogram was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. Treatment response was assessed by determining the serum and urinary levels of M-proteins, serum-free light chain ratio, and the percentage of bone marrow plasma cells. RESULTS Thirteen features were selected to build a radiomic signature. The International Staging System (ISS) stage was selected as an independent clinical factor. The radiomic signature and nomogram showed better calibration and higher discriminatory capacity (AUC of 0.929 and 0.917 for the radiomics and nomogram in the training cohort, respectively, and 0.862 and 0.874 for the radiomics and nomogram in the test cohort, respectively) than the clinical model (AUC of 0.661 and 0.674 in the training and test cohort, respectively). Decision curve analysis confirmed the clinical utility of the radiomics model. CONCLUSIONS Nomograms incorporating a magnetic resonance imaging-based radiomic signature and ISS stage help predict the response to chemotherapy for MM and can be useful in clinical decision-making.
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Affiliation(s)
| | - Tiantian Bian
- Breast Disease Center, the Affiliated Hospital of Qingdao University, Qingdao, Shandong
| | | | | | - Hairong Fei
- Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Automated prediction of the neoadjuvant chemotherapy response in osteosarcoma with deep learning and an MRI-based radiomics nomogram. Eur Radiol 2022; 32:6196-6206. [PMID: 35364712 DOI: 10.1007/s00330-022-08735-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/22/2022] [Accepted: 03/05/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To implement a pipeline to automatically segment the ROI and to use a nomogram integrating the MRI-based radiomics score and clinical variables to predict responses to neoadjuvant chemotherapy (NAC) in osteosarcoma patients. METHODS A total of 144 osteosarcoma patients treated with NAC were separated into training (n = 101) and test (n = 43) groups. After normalisation, ROIs for the preoperative MRI were segmented by a deep learning segmentation model trained with nnU-Net by using two independent manual segmentations as labels. Radiomics features were extracted using automatically segmented ROIs. Feature selection was performed in the training dataset by five-fold cross-validation. The clinical, radiomics, and clinical-radiomics models were built using multiple machine learning methods with the same training dataset and validated with the same test dataset. The segmentation model was evaluated by the Dice coefficient. AUC and decision curve analysis (DCA) were employed to illustrate the model performance and clinical utility. RESULTS 36/144 (25.0%) patients were pathological good responders (pGRs) to NAC, while 108/144 (75.0%) were non-pGRs. The segmentation model achieved a Dice coefficient of 0.869 on the test dataset. The clinical and radiomics models reached AUCs of 0.636 with a 95% confidence interval (CI) of 0.427-0.860 and 0.759 (95% CI, 0.589-0.937), respectively, in the test dataset. The clinical-radiomics nomogram demonstrated good discrimination, with an AUC of 0.793 (95% CI, 0.610-0.975), and accuracy of 79.1%. The DCA suggested the clinical utility of the nomogram. CONCLUSION The automatic nomogram could be applied to aid radiologists in identifying pGRs to NAC. KEY POINTS • The nnU-Net trained by manual labels enables the use of an automatic segmentation tool for ROI delineation of osteosarcoma. • A pipeline using automatic lesion segmentation and followed by a radiomics classifier could aid the evaluation of NAC response of osteosarcoma. • A predictive nomogram composed of clinical variables and MRI-based radiomics score provides support for individualised treatment planning.
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17
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Luo Z, Li J, Liao Y, Liu R, Shen X, Chen W. Radiomics Analysis of Multiparametric MRI for Prediction of Synchronous Lung Metastases in Osteosarcoma. Front Oncol 2022; 12:802234. [PMID: 35273911 PMCID: PMC8901998 DOI: 10.3389/fonc.2022.802234] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/31/2022] [Indexed: 12/22/2022] Open
Abstract
Purpose To establish and verify a predictive model involving multiparameter MRI and clinical manifestations for predicting synchronous lung metastases (SLM) in osteosarcoma. Materials and Methods Seventy-eight consecutive patients with osteosarcoma (training dataset, n = 54; validation dataset, n = 24) were enrolled in our study. MRI features were extracted from the T1‐weighted image (T1WI), T2‐weighted image (T2WI), and contrast-enhanced T1-weighted image (CE-T1WI) of each patient. Least absolute shrinkage and selection operator (LASSO) regression and multifactor logistic regression were performed to select key features and build radiomics models in conjunction with logistic regression (LR) and support vector machine (SVM) classifiers. Eight individual models based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI+CE-T1WI, T2WI+CE-T1WI, T1WI+T2WI+CE-T1WI, and clinical features, as well as two combined models, were built. The area under the receiver operating characteristic curve (AUC), sensitivity and specificity were employed to assess the different models. Results Tumor size was the most significant univariate clinical indicator (1). The AUC values of the LR predictive model based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI+CE-T1WI, T2WI+CE-T1WI, and T1WI+T2WI+CE-T1WI were 0.686, 0.85, 0.87, 0.879, 0.736, 0.85, and 0.914, respectively (2). The AUC values of the SVM predictive model based on T1WI, T2WI, CE-T1WI, T1WI+T2WI, T1WI +CE-T1WI, T2WI +CE-T1WI, and T1WI+T2WI+CE-T1WI were 0.629, 0.829, 0.771, 0.879, 0.643, 0.829, and 0.929, respectively (3). The AUC values of the clinical, combined 1 (clinical and LR-radiomics) and combined 2 (clinical and SVM-radiomics) predictive models were 0.779, 0.957, and 0.943, respectively. Conclusion The combined model exhibited good performance in predicting osteosarcoma SLM and may be helpful in clinical decision-making.
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Affiliation(s)
- Zhendong Luo
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Jing Li
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - YuTing Liao
- Department of Pharmaceuticals Diagnosis, GE Healthcare, Shanghai, China
| | - RengYi Liu
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinping Shen
- Department of Radiology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Weiguo Chen
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Sun YF, Wang Y, Li XD, Wang H. SNHG15, a p53-regulated lncRNA, suppresses cisplatin-induced apoptosis and ROS accumulation through the miR-335-3p/ZNF32 axis. Am J Cancer Res 2022; 12:816-828. [PMID: 35261804 PMCID: PMC8899989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023] Open
Abstract
Small nucleolar RNA host gene 15 (SNHG15) is upregulated in many malignancies and mediates the development of multiple cancers, including osteosarcoma (OS). However, data on the regulatory mechanisms and role of SNHG15 in the chemoresistance of OS remain scarce. Here, we show that p53 binds to the SNHG15 promoter, leading to decreased SNHG15 expression. Decreased SNHG15 expression promotes cisplatin-induced apoptosis and reactive oxygen species (ROS) accumulation in OS cells. Furthermore, SNHG15 sponges and inhibits the activity of endogenous miR-335-3p, leading to the upregulation of zinc finger protein 32 (ZNF32). Taken together, these findings reveal that p53 downregulates SNHG15 expression in OS. In addition, SNHG15 suppresses cisplatin-induced apoptosis and ROS accumulation through the miR-335-3p/ZNF32 pathway.
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Affiliation(s)
- Yue-Feng Sun
- Department of Spine Surgery, First Affiliated Hospital & Institute of Cancer Stem Cell Dalian Medical UniversityDalian 116011, Liaoning, China
| | - Yuan Wang
- The Second Affiliated Hospital, Dalian Medical UniversityDalian 116044, Liaoning, China
| | - Xiao-Dong Li
- Department of Spine Surgery, First Affiliated Hospital & Institute of Cancer Stem Cell Dalian Medical UniversityDalian 116011, Liaoning, China
| | - Hong Wang
- Department of Spine Surgery, Dalian Municipal Central HospitalDalian 116022, Liaoning, China
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Radiomics of Musculoskeletal Sarcomas: A Narrative Review. J Imaging 2022; 8:jimaging8020045. [PMID: 35200747 PMCID: PMC8876222 DOI: 10.3390/jimaging8020045] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 12/23/2022] Open
Abstract
Bone and soft-tissue primary malignant tumors or sarcomas are a large, diverse group of mesenchymal-derived malignancies. They represent a model for intra- and intertumoral heterogeneities, making them particularly suitable for radiomics analyses. Radiomic features offer information on cancer phenotype as well as the tumor microenvironment which, combined with other pertinent data such as genomics and proteomics and correlated with outcomes data, can produce accurate, robust, evidence-based, clinical-decision support systems. Our purpose in this narrative review is to offer an overview of radiomics studies dealing with Magnetic Resonance Imaging (MRI)-based radiomics models of bone and soft-tissue sarcomas that could help distinguish different histotypes, low-grade from high-grade sarcomas, predict response to multimodality therapy, and thus better tailor patients’ treatments and finally improve their survivals. Although showing promising results, interobserver segmentation variability, feature reproducibility, and model validation are three main challenges of radiomics that need to be addressed in order to translate radiomics studies to clinical applications. These efforts, together with a better knowledge and application of the “Radiomics Quality Score” and Image Biomarker Standardization Initiative reporting guidelines, could improve the quality of sarcoma radiomics studies and facilitate radiomics towards clinical translation.
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Wang T, Wang H, Wang Y, Liu X, Ling L, Zhang G, Yang G, Zhang H. MR-based radiomics-clinical nomogram in epithelial ovarian tumor prognosis prediction: tumor body texture analysis across various acquisition protocols. J Ovarian Res 2022; 15:6. [PMID: 35022079 PMCID: PMC8753904 DOI: 10.1186/s13048-021-00941-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background Epithelial ovarian cancer (EOC) is the most malignant gynecological tumor in women. This study aimed to construct and compare radiomics-clinical nomograms based on MR images in EOC prognosis prediction. Methods A total of 186 patients with pathologically proven EOC were enrolled and randomly divided into a training cohort (n = 130) and a validation cohort (n = 56). Clinical characteristics of each patient were retrieved from the hospital information system. A total of 1116 radiomics features were extracted from tumor body on T2-weighted imaging (T2WI), T1-weighted imaging (T1WI), diffusion weighted imaging (DWI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Paired sequence signatures were constructed, selected and trained to build a prognosis prediction model. Radiomic-clinical nomogram was constructed based on multivariate logistic regression analysis with radiomics score and clinical features. The predictive performance was evaluated by receiver operating characteristic curve (ROC) analysis, decision curve analysis (DCA) and calibration curve. Results The T2WI radiomic-clinical nomogram achieved a favorable prediction performance in the training and validation cohort with an area under ROC curve (AUC) of 0.866 and 0.818, respectively. The DCA showed that the T2WI radiomic-clinical nomogram was better than other models with a greater clinical net benefit. Conclusion MR-based radiomics analysis showed the high accuracy in prognostic estimation of EOC patients and could help to predict therapeutic outcome before treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s13048-021-00941-7.
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Affiliation(s)
- Tianping Wang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Haijie Wang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Yida Wang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Xuefen Liu
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Lei Ling
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Guofu Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Guang Yang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - He Zhang
- Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
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Texture Analysis of Computed Tomography Images in the Lung of Patients With Breast Cancer. J Comput Assist Tomogr 2021; 45:837-842. [PMID: 34347709 DOI: 10.1097/rct.0000000000001198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether the texture features of lung computed tomography images were altered by primary breast cancer without pulmonary metastasis. METHODS Texture analysis was performed on the regions of interest of lung computed tomography images from 36 patients with breast cancer and 36 healthy controls. Texture parameters between subjects with different clinical stages and hormone receptor (HR) statuses in patients with breast cancer were analyzed. RESULTS Three texture parameters (mean, SD, and variance) were significantly different between patients with breast cancer and healthy controls and between preoperative and postoperative stages in patients with breast cancer. All 3 parameters showed an increasing trend under the tumor-bearing state. These parameters were significantly higher in the stage III + IV group than in the stage I + II group. The variance parameter was significantly higher in the HR-negative group than in the HR-positive group. CONCLUSIONS Texture analysis may serve as a novel additional tool for discovering conventionally invisible changes in the lung tissue of patients with breast cancer.
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Sun R, Lerousseau M, Henry T, Carré A, Leroy A, Estienne T, Niyoteka S, Bockel S, Rouyar A, Alvarez Andres É, Benzazon N, Battistella E, Classe M, Robert C, Scoazec JY, Deutsch É. [Artificial intelligence, radiomics and pathomics to predict response and survival of patients treated with radiations]. Cancer Radiother 2021; 25:630-637. [PMID: 34284970 DOI: 10.1016/j.canrad.2021.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/19/2021] [Indexed: 12/24/2022]
Abstract
Artificial intelligence approaches in medicine are more and more used and are extremely promising due to the growing number of data produced and the variety of data they allow to exploit. Thus, the computational analysis of medical images in particular, radiological (radiomics), or anatomopathological (pathomics), has shown many very interesting results for the prediction of the prognosis and the response of cancer patients. Radiotherapy is a discipline that particularly benefits from these new approaches based on computer science and imaging. This review will present the main principles of an artificial intelligence approach and in particular machine learning, the principles of a radiomic and pathomic approach and the potential of their use for the prediction of the prognosis of patients treated with radiotherapy.
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Affiliation(s)
- R Sun
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France; Département de radiothérapie, Gustave-Roussy Cancer Campus, 94800 Villejuif, France; Faculté de médecine, université Paris-Sud Paris-Saclay, 94270 Kremlin-Bicêtre, France.
| | - M Lerousseau
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | - T Henry
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France; Département de médecine nucléaire, Gustave-Roussy Cancer Campus, 94800 Villejuif, France
| | - A Carré
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | - A Leroy
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France; TheraPanacea, Paris, France
| | - T Estienne
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | - S Niyoteka
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | - S Bockel
- Département de radiothérapie, Gustave-Roussy Cancer Campus, 94800 Villejuif, France; Faculté de médecine, université Paris-Sud Paris-Saclay, 94270 Kremlin-Bicêtre, France
| | - A Rouyar
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | - É Alvarez Andres
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France; TheraPanacea, Paris, France
| | - N Benzazon
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | - E Battistella
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France
| | | | - C Robert
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France; Département de radiothérapie, Gustave-Roussy Cancer Campus, 94800 Villejuif, France; Faculté de médecine, université Paris-Sud Paris-Saclay, 94270 Kremlin-Bicêtre, France
| | - J Y Scoazec
- Faculté de médecine, université Paris-Sud Paris-Saclay, 94270 Kremlin-Bicêtre, France; Département de biologie et pathologie médicales, Gustave-Roussy Cancer Campus, 94800 Villejuif, France
| | - É Deutsch
- Université Paris-Saclay, institut Gustave-Roussy, Inserm, Radiothérapie moléculaire et innovation thérapeutique, 94800 Villejuif, France; Département de radiothérapie, Gustave-Roussy Cancer Campus, 94800 Villejuif, France; Faculté de médecine, université Paris-Sud Paris-Saclay, 94270 Kremlin-Bicêtre, France
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Vertebral MRI-based radiomics model to differentiate multiple myeloma from metastases: influence of features number on logistic regression model performance. Eur Radiol 2021; 32:572-581. [PMID: 34255157 DOI: 10.1007/s00330-021-08150-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/09/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aimed to use the most frequent features to establish a vertebral MRI-based radiomics model that could differentiate multiple myeloma (MM) from metastases and compare the model performance with different features number. METHODS We retrospectively analyzed conventional MRI (T1WI and fat-suppression T2WI) of 103 MM patients and 138 patients with metastases. The feature selection process included four steps. The first three steps defined as conventional feature selection (CFS), carried out 50 times (ten times with 5-fold cross-validation), included variance threshold, SelectKBest, and least absolute shrinkage and selection operator. The most frequent fixed features were selected for modeling during the last step. The number of events per independent variable (EPV) is the number of patients in a smaller subgroup divided by the number of radiomics features considered in developing the prediction model. The EPV values considered were 5, 10, 15, and 20. Therefore, we constructed four models using the top 16, 8, 6, and 4 most frequent features, respectively. The models constructed with features selected by CFS were also compared. RESULTS The AUCs of 20EPV-Model, 15EPV-Model, and CSF-Model (AUC = 0.71, 0.81, and 0.78) were poor than 10EPV-Model (AUC = 0.84, p < 0.001). The AUC of 10EPV-Model was comparable with 5EPV-Model (AUC = 0.85, p = 0.480). CONCLUSIONS The radiomics model constructed with an appropriate small number of the most frequent features could well distinguish metastases from MM based on conventional vertebral MRI. Based on our results, we recommend following the 10 EPV as the rule of thumb for feature selection. KEY POINTS • The developed radiomics model could distinguish metastases from multiple myeloma based on conventional vertebral MRI. • An accurate model based on just a handful of the most frequent features could be constructed by utilizing multiple feature reduction techniques. • An event per independent variable value of 10 is recommended as a rule of thumb for modeling feature selection.
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Gitto S, Cuocolo R, Albano D, Morelli F, Pescatori LC, Messina C, Imbriaco M, Sconfienza LM. CT and MRI radiomics of bone and soft-tissue sarcomas: a systematic review of reproducibility and validation strategies. Insights Imaging 2021; 12:68. [PMID: 34076740 PMCID: PMC8172744 DOI: 10.1186/s13244-021-01008-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
Background Feature reproducibility and model validation are two main challenges of radiomics. This study aims to systematically review radiomic feature reproducibility and predictive model validation strategies in studies dealing with CT and MRI radiomics of bone and soft-tissue sarcomas. The ultimate goal is to promote achieving a consensus on these aspects in radiomic workflows and facilitate clinical transferability. Results Out of 278 identified papers, forty-nine papers published between 2008 and 2020 were included. They dealt with radiomics of bone (n = 12) or soft-tissue (n = 37) tumors. Eighteen (37%) studies included a feature reproducibility analysis. Inter-/intra-reader segmentation variability was the theme of reproducibility analysis in 16 (33%) investigations, outnumbering the analyses focused on image acquisition or post-processing (n = 2, 4%). The intraclass correlation coefficient was the most commonly used statistical method to assess reproducibility, which ranged from 0.6 and 0.9. At least one machine learning validation technique was used for model development in 25 (51%) papers, and K-fold cross-validation was the most commonly employed. A clinical validation of the model was reported in 19 (39%) papers. It was performed using a separate dataset from the primary institution (i.e., internal validation) in 14 (29%) studies and an independent dataset related to different scanners or from another institution (i.e., independent validation) in 5 (10%) studies. Conclusions The issues of radiomic feature reproducibility and model validation varied largely among the studies dealing with musculoskeletal sarcomas and should be addressed in future investigations to bring the field of radiomics from a preclinical research area to the clinical stage.
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Affiliation(s)
- Salvatore Gitto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
| | - Renato Cuocolo
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Naples, Italy.,Laboratory of Augmented Reality for Health Monitoring (ARHeMLab), Dipartimento di Ingegneria Elettrica e delle Tecnologie dell'Informazione, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | | | - Lorenzo Carlo Pescatori
- Assistance Publique - Hôpitaux de Paris (AP-HP), Service d'Imagerie Médicale, CHU Henri Mondor, Créteil, France
| | - Carmelo Messina
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Massimo Imbriaco
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Luca Maria Sconfienza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Chianca V, Albano D, Messina C, Vincenzo G, Rizzo S, Del Grande F, Sconfienza LM. An update in musculoskeletal tumors: from quantitative imaging to radiomics. Radiol Med 2021; 126:1095-1105. [PMID: 34009541 DOI: 10.1007/s11547-021-01368-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/02/2021] [Indexed: 02/08/2023]
Abstract
In the last two decades, relevant progress has been made in the diagnosis of musculoskeletal tumors due to the development of new imaging tools, such as diffusion-weighted imaging, diffusion kurtosis imaging, magnetic resonance spectroscopy, and diffusion tensor imaging. Another important role has been played by the development of artificial intelligence software based on complex algorithms, which employ computing power in the detection of specific tumor types. The aim of this article is to report the most advanced imaging techniques focusing on their advantages in clinical practice.
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Affiliation(s)
- Vito Chianca
- Clinica di Radiologia EOC IIMSI, Lugano, Switzerland. .,Ospedale Evangelico Betania, Napoli, Italy. .,Master in Oncologic Imaging, Diagnostic and Interventional Radiology Department of Translational Research, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Sezione di Scienze Radiologiche, Dipartimento Di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Dipartimento di Scienze Biomediche Per La Salute, Università degli Studi di Milano, Milano, Italy
| | | | | | | | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.,Dipartimento di Scienze Biomediche Per La Salute, Università degli Studi di Milano, Milano, Italy
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26
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Wang Q, Zhang Y, Zhang E, Xing X, Chen Y, Su MY, Lang N. Prediction of the early recurrence in spinal giant cell tumor of bone using radiomics of preoperative CT: Long-term outcome of 62 consecutive patients. J Bone Oncol 2021; 27:100354. [PMID: 33850701 PMCID: PMC8039834 DOI: 10.1016/j.jbo.2021.100354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 12/27/2022] Open
Abstract
Characteristics of 62 patients with spinal GCTB who underwent surgery. A prognostic classification model was built based on features selected by SVM. The combined histogram and texture features could predict recurrence of GCTB.
Objectives To determine if radiomics analysis based on preoperative computed tomography (CT) can predict early postoperative recurrence of giant cell tumor of bone (GCTB) in the spine. Methods In a retrospective review, 62 patients with pathologically confirmed spinal GCTB from March 2008 to February 2018, with a minimum follow-up of 24 months, were identified. The mean follow-up was 73.7 months (range, 28.7–152.1 months). The clinical information including age, gender, lesion location, multi-vertebral involvement, and surgical methods, were obtained. CT images acquired before the operation were retrieved for radiomics analysis. For each case, the tumor regions of interest (ROI) was manually outlined, and a total of 107 radiomics features were extracted. The features were selected via the sequential selection process by using the support vector machine (SVM), then used to construct classification models with Gaussian kernels. The differentiation between recurrence and non-recurrence groups was evaluated by ROC analysis, using 10-fold cross-validation. Results Of the 62 patients, 17 had recurrence with a recurrence rate of 27.4%. None of the clinical information was significantly different between the two groups. Patients receiving curettage had a higher recurrence rate (6/16 = 37.5%) compared to patients receiving TES (6/26 = 23.1%) or intralesional spondylectomy (5/20 = 25%). The final radiomics model was built using 10 selected features, which achieved an accuracy of 89% with AUC of 0.78. Conclusions The radiomics model developed based on pre-operative CT can achieve a high accuracy to predict the recurrence of spinal GCTB. Patients who have a high risk of early recurrence should be treated more aggressively to minimize recurrence.
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Key Words
- CT texture analysis
- CT, Computed Tomography
- DICOM, Digital Imaging and Communications in Medicine
- GCTB, Giant Cell Tumor of Bone
- GLCM, Gray Level Co-occurrence Matrix
- GLDM, Gray Level Dependence Matrix
- GLRLM, Gray Level Run Length Matrix
- GLSZM, Gray Level Size Zone Matrix
- Giant cell tumor of bone
- MRI, Magnetic Resonance Imaging
- NGTDM, Neighborhood Gray Tone Difference Matrix
- OPG, Osteoprotegerin
- PACS, Picture Archiving and Communication System
- Prognosis
- RANK, Receptor Activator of Nuclear factor Kappa-Β
- RANKL, Receptor Activator of Nuclear factor Kappa-Β Ligand
- ROC, Receiver Operating Characteristic
- ROI, Regions of Interest
- Radiomics
- SVM, Support Vector Machine
- Spine
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Affiliation(s)
- Qizheng Wang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Yang Zhang
- 164 Irvine Hall, Center for Functional Onco-Imaging, University of California, Irvine, CA 92697-5020, USA.,Department of Radiation Oncology, Rutgers-Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Enlong Zhang
- Department of Radiology, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Chang Ping District, Beijing 100191, China
| | - Xiaoying Xing
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
| | - Min-Ying Su
- 164 Irvine Hall, Center for Functional Onco-Imaging, University of California, Irvine, CA 92697-5020, USA.,Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China
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Ma G, Kang J, Qiao N, Zhang B, Chen X, Li G, Gao Z, Gui S. Non-Invasive Radiomics Approach Predict Invasiveness of Adamantinomatous Craniopharyngioma Before Surgery. Front Oncol 2021; 10:599888. [PMID: 33680925 PMCID: PMC7925821 DOI: 10.3389/fonc.2020.599888] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/30/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose Craniopharyngiomas (CPs) are benign tumors, complete tumor resection is considered to be the optimal treatment. However, although histologically benign, the local invasiveness of CPs commonly contributes to incomplete resection and a poor prognosis. At present, some advocate less aggressive surgery combined with radiotherapy as a more reasonable and effective means of protecting hypothalamus function and preventing recurrence in patients with tight tumor adhesion to the hypothalamus. Hence, if a method can be developed to predict the invasiveness of CP preoperatively, it will help in the development of a more personalized surgical strategy. The aim of the study was to report a radiomics-clinical nomogram for the individualized preoperative prediction of the invasiveness of adamantinomatous CP (ACPs) before surgery. Methods In total, 1,874 radiomics features were extracted from whole tumors on contrast-enhanced T1-weighted images. A support vector machine trained a predictive model that was validated using receiver operating characteristic (ROC) analysis on an independent test set. Moreover, a nomogram was constructed incorporating clinical characteristics and the radiomics signature for individual prediction. Results Eleven features associated with the invasiveness of ACPs were selected by using the least absolute shrinkage and selection operator (LASSO) method. These features yielded area under the curve (AUC) values of 79.09 and 73.5% for the training and test sets, respectively. The nomogram incorporating peritumoral edema and the radiomics signature yielded good calibration in the training and test sets with the AUCs of 84.79 and 76.48%, respectively. Conclusion The developed model yields good performance, indicating that the invasiveness of APCs can be predicted using noninvasive radiological data. This reliable, noninvasive tool can help clinical decision making and improve patient prognosis.
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Affiliation(s)
- Guofo Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jie Kang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ning Qiao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bochao Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xuzhu Chen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guilin Li
- Neuropathology Department, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhixian Gao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Songbai Gui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Baidya Kayal E, Kandasamy D, Khare K, Bakhshi S, Sharma R, Mehndiratta A. Texture analysis for chemotherapy response evaluation in osteosarcoma using MR imaging. NMR IN BIOMEDICINE 2021; 34:e4426. [PMID: 33078438 DOI: 10.1002/nbm.4426] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 06/11/2023]
Abstract
The efficacy of MRI-based statistical texture analysis (TA) in predicting chemotherapy response among patients with osteosarcoma was assessed. Forty patients (male: female = 31:9; age = 17.2 ± 5.7 years) with biopsy-proven osteosarcoma were analyzed in this prospective study. Patients were scheduled for three cycles of neoadjuvant chemotherapy (NACT) and diffusion-weighted MRI acquisition at three time points: at baseline (t0), after the first NACT (t1) and after the third NACT (t2) using a 1.5 T scanner. Eight patients (nonsurvivors) died during NACT while 34 patients (survivors) completed the NACT regimen followed by surgery. Histopathological evaluation was performed in the resected tumor to assess NACT response (responder [≤50% viable tumor] and nonresponder [>50% viable tumor]) and revealed nonresponder: responder = 20:12. Apparent diffusion coefficient (ADC) and intravoxel incoherent motion (IVIM) parameters, diffusion coefficient (D), perfusion coefficient (D*) and perfusion fraction (f) were evaluated. A total of 25 textural features were evaluated on ADC, D, D* and f parametric maps and structural T1-weighted (T1W) and T2-weighted (T2W) images in the entire tumor volume using 3D TA methods gray-level cooccurrence matrix (GLCM), neighborhood gray-tone-difference matrix (NGTDM) and run-length matrix (RLM). Receiver-operating-characteristic curve analysis was performed on the selected textural feature set to assess the role of TA features (a) as marker(s) of tumor aggressiveness leading to mortality at baseline and (b) in predicting the NACT response among survivors in the course of treatment. Findings showed that the NGTDM features coarseness, busyness and strength quantifying tumor heterogeneity in D, D* and f maps and T1W and T2W images were useful markers of tumor aggressiveness in identifying the nonsurvivor group (area-under-the-curve [AUC] = 0.82-0.88) at baseline. The GLCM features contrast and correlation, NGTDM features contrast and complexity and RLM feature short-run-low-gray-level-emphasis quantifying homogeneity/terogeneity in tumor were effective markers for predicting chemotherapeutic response using D (AUC = 0.80), D* (AUC = 0.80) and T2W (AUC = 0.70) at t0, and D* (AUC = 0.80) and f (AUC = 0.70) at t1. 3D statistical TA features might be useful as imaging-based markers for characterizing tumor aggressiveness and predicting chemotherapeutic response in patients with osteosarcoma.
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Affiliation(s)
- Esha Baidya Kayal
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | | | - Kedar Khare
- Department of Physics, Indian Institute of Technology Delhi, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr. B.R. Ambedkar Institute-Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
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Estimating the Potential of Radiomics Features and Radiomics Signature from Pretherapeutic PSMA-PET-CT Scans and Clinical Data for Prediction of Overall Survival When Treated with 177Lu-PSMA. Diagnostics (Basel) 2021; 11:diagnostics11020186. [PMID: 33525456 PMCID: PMC7912143 DOI: 10.3390/diagnostics11020186] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 12/30/2022] Open
Abstract
Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PSMA-PET/CT) scans can facilitate diagnosis and treatment of prostate disease. Radiomics signature (RS) is widely used for the analysis of overall survival (OS) in cancer diseases. This study aims at investigating the role of radiomics features (RFs) and RS from pretherapeutic gallium-68 (68Ga)-PSMA-PET/CT findings and patient-specific clinical parameters to analyze overall survival of prostate cancer (PC) patients when treated with lutethium-177 (177Lu)-PSMA. A cohort of 83 patients with advanced PC was retrospectively analyzed. Average values of 73 RFs of 2070 malignant hotspots as well as 22 clinical parameters were analyzed for each patient. From the Cox proportional hazard model, the least absolute shrinkage and selection operator (LASSO) regularization method is used to select most relevant features (standardized uptake value (SUV)Min and kurtosis with the coefficients of 0.984 and −0.118, respectively) and to calculate the RS from the RFs. Kaplan–Meier (KM) estimator was used to analyze the potential of RFs and conventional clinical parameters, such as metabolic tumor volume (MTV) and standardized uptake value (SUV) for the prediction of survival. As a result, SUVMin, kurtosis, the calculated RS, SUVMean, as well as Hemoglobin (Hb)1, C-reactive protein (CRP)1, and ECOG1 (clinical parameters) achieved p-values less than 0.05, which suggest the potential of findings from 68Ga-PSMA-PET/CT scans as well as patient-specific clinical parameters for the prediction of OS for patients with advanced PC treated with 177Lu-PSMA therapy.
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30
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Sun F, Chen Y, Chen X, Sun X, Xing L. CT-based radiomics for predicting brain metastases as the first failure in patients with curatively resected locally advanced non-small cell lung cancer. Eur J Radiol 2020; 134:109411. [PMID: 33246270 DOI: 10.1016/j.ejrad.2020.109411] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/02/2020] [Accepted: 11/08/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Brain metastasis (BM) is the primary first failure pattern in patients with curatively resected locally advanced non-small cell lung cancer (LA-NSCLC). It is not yet possible to accurately predict the occurrence of BM. The purpose of the research is to develop and validate a prediction model of BM-free survival based on radiomics characterising the primary lesions combined with clinical characteristics in patients with curatively resected LA-NSCLC. METHODS This study consisted of 124 patients with curatively resected stage IIB-IIIB NSCLC in our institution between January 2014 and June 2018. Patients were randomly divided into training and validation cohorts using a 4:1 ratio. Radiomics features were selected from the chest CT images before surgery. A radiomics signature was constructed using the LASSO algorithm based on the training cohort. Clinical model was developed using the Cox proportional hazards model. The clinical, radiomics, and integrated nomograms were constructed. The prediction performance of the models was assessed based on its discrimination, calibration, and clinical utility. RESULTS The radiomics signature is significantly associated with BM-free survival in the overall cohort. The discrimination performance of the integrated nomogram, with the C-indexes 0.889 (0.872-0.906, 95 % CI) and 0.853 (0.788-0.918, 95 % CI) in the training and validation cohorts, respectively, is significantly better than the clinical nomogram (p < 0.0001 for the training cohort, p = 0.0008 for the validation cohort). Compared with the radiomics nomogram, the integrated nomogram is also improved to varying degrees, but not apparent in the validation cohort (p = 0.0007 for the training cohort, p = 0.0554 for the validation cohort). The calibration curve and decision curve analysis demonstrated that the integrated nomogram exceeded the clinical or radiomics nomograms in predicting BM-free survival. CONCLUSIONS Compared with the clinical or radiomics nomograms, the predictive performance of the integrated nomogram is significantly improved. The integrated nomogram is most suitable for predicting BM-free survival in patients with curatively resected LA-NSCLC.
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Affiliation(s)
- Fenghao Sun
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China; Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China.
| | - Yicong Chen
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China; Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xia Chen
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China; Department of Graduate, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiaorong Sun
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China; Department of Graduate, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
| | - Ligang Xing
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China; Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, Shandong, China; Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Department of Graduate, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
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Huang W, Yan YG, Wang WJ, Ouyang ZH, Li XL, Zhang TL, Wang XB, Wang B, Lv GH, Li J, Zou MX. Development and Validation of a 6-miRNA Prognostic Signature in Spinal Chordoma. Front Oncol 2020; 10:556902. [PMID: 33194623 PMCID: PMC7656123 DOI: 10.3389/fonc.2020.556902] [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: 04/29/2020] [Accepted: 09/29/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Published data have suggested a critical role for microRNA (miRNA) expression in chordoma progression. However, most of these studies focus on single miRNA and no multi-miRNA prognostic signature has been currently established for chordoma. In this study, we sought to develop and validate a 6-miRNA risk score (miRscore) model for survival prediction. METHODS Medline, Embase, and Google scholar searches (from inception to July 20, 2018) were conducted to identify candidate miRNAs with prognostic value as per predefined criteria. Quantitative RT-PCR was used to measure miRNA levels in 114 spinal chordoma (54 in the training and 60 in the validation cohort) and 20 control specimens. Subsequently, the miRscore was built based on miRNAs data. RESULTS Literature searches identified six prognostic miRNAs (miR-574-3p, miR-1237-3p, miR-140-3p, miR-1, miR-155, and miR-1290) with differential expression in tumor tissues. Bioinformatical analysis revealed an important regulatory role for miR-574-3p/EGFR signaling in chordoma and showed that the target genes of these prognostic miRNAs were mainly enriched in transcription regulation, protein binding and cancer-related pathways. In both cohorts, the miRscore was associated with surrounding muscle invasion by tumor and/or other aggressive features. The miRscore model well predicted local recurrence-free survival and overall survival, which remained after adjusting for other relevant covariates. Further time-dependent receiver operating characteristics analysis in the two cohorts found that the miRscore classifier had stronger prognostic power than known clinical predictors and improved the ability of Enneking staging to predict outcomes. Importantly, recursive-partitioning analysis of both samples combined separated patients into four prognostically distinct risk subgroups for recurrence and survival (both P < 0.001). CONCLUSIONS These data suggest the miRscore as a useful prognostic stratification tool in spinal chordoma and may represent an important step toward future personalized treatment of patients.
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Affiliation(s)
- Wei Huang
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
- Health Management Center, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Yi-Guo Yan
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Wen-Jun Wang
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Zhi-Hua Ouyang
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Xue-Lin Li
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Tao-Lan Zhang
- Department of Cancer Biology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
| | - Xiao-Bin Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Guo-Hua Lv
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jing Li
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ming-Xiang Zou
- Department of Spine Surgery, The First Affiliated Hospital, University of South China, Hengyang, China
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
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Revisiting the WHO classification system of bone tumours: emphasis on advanced magnetic resonance imaging sequences. Part 2. Pol J Radiol 2020; 85:e409-e419. [PMID: 32999694 PMCID: PMC7509892 DOI: 10.5114/pjr.2020.98686] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
Similarly to soft tissue tumours, the World Health Organisation (WHO) classification categorises bone tumours based on their similarity to normal adult tissue. The most recent WHO classification provides an updated classification scheme that integrates the biological behaviour of bone tumours, particularly cartilage-forming tumours, and tumours are now further subdivided as benign, intermediate (locally aggressive or rarely metastasising), and malignant. Radiologists play an important role in the detection and initial characterisation of bone tumours, with careful analysis of their matrix mineralisation, location, and overall anatomic extent including extra-compartmental extension and neurovascular invasion. Radiography remains central to the detection and characterisation of bone tumours; however, magnetic resonance imaging (MRI) is the ideal modality for local staging. This review will discuss the most recent updates to the WHO classification of bone tumours that are relevant to radiologists in routine clinical practice. The utility of advanced MRI sequences such as diffusion-weighted imaging, dynamic contrast enhanced sequences, and magnetic resonance spectroscopy that may provide insight into the biological behaviour of various bone tumours is highlighted.
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Diffusion Kurtosis Imaging as a Prognostic Marker in Osteosarcoma Patients with Preoperative Chemotherapy. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3268138. [PMID: 33029501 PMCID: PMC7533782 DOI: 10.1155/2020/3268138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/28/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022]
Abstract
Background The accurate prediction of prognosis is key to prompt therapy adjustment. The purpose of our study was to investigate the efficacy of diffusion kurtosis imaging (DKI) in predicting progression-free survival (PFS) and overall survival (OS) in osteosarcoma patients with preoperative chemotherapy. Methods Thirty patients who underwent DKI before and after chemotherapy, followed by tumor resection, were retrospectively enrolled. The patients were grouped into good responders (GRs) and poor responders (PRs). The Kaplan-Meier and log-rank test were used for survival analysis. The association between the DKI parameters and OS and PFS was performed by univariate and multivariate Cox proportional hazards models. Results Significantly worse OS and PFS were associated with a lower mean diffusivity (MD) after chemotherapy (HR, 5.8; 95% CI, 1.5-23.1; P = 0.012 and HR, 3.5; 95% CI, 1.2-10.1: P = 0.028, respectively) and a higher mean kurtosis (MK) after chemotherapy (HR, 0.3; 95% CI, 0.1-0.9; P = 0.041 and HR, 0.3; 95% CI, 0.1-0.8; P = 0.049, respectively). Likewise, shorter OS and PFS were also significantly associated with a change rate in MD (CR MD) of less than 13.53% (HR, 8.6; 95% CI, 1.8-41.8; P = 0.007 and HR, 2.9; 95% CI, 1.0-8.2; P = 0.045, respectively). Compared to GRs, PRs had an approximately 9- and 4-fold increased risk of death (HR, 9.4; 95% CI, 1.2-75; P = 0.034) and progression (HR, 4.2; 95% CI, 1.2-15; P = 0.026), respectively. Conclusions DKI has a potential to be a prognostic tool in osteosarcoma. Low MK and high MD after chemotherapy or high CR MD indicates favorite outcome, while prospective studies with large sample sizes are warranted.
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Zhong J, Hu Y, Si L, Jia G, Xing Y, Zhang H, Yao W. A systematic review of radiomics in osteosarcoma: utilizing radiomics quality score as a tool promoting clinical translation. Eur Radiol 2020; 31:1526-1535. [PMID: 32876837 DOI: 10.1007/s00330-020-07221-w] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/12/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To assess the methodological quality and risk of bias in radiomics studies investigating diagnosis, therapy response, and survival of patients with osteosarcoma. METHODS In this systematic review, literatures on radiomics in osteosarcoma were included and assessed for methodological quality through the radiomics quality score (RQS). The risk of bias and concern of application was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A meta-analysis of studies focusing on predicting osteosarcoma response to neoadjuvant chemotherapy was performed. RESULTS Twelve radiomics studies exploring osteosarcoma were identified, and five were included in meta-analysis. The RQS reached an average of 20.4% (6.92 of 36) with good inter-rater agreement (ICC 0.95, 95% CI 0.85-0.99). Four studies validated results with an internal dataset, none of which used external dataset; one study was prospectively designed, and another one shared part of the dataset. The risk of bias and concern of application were mainly related to index test aspect. The meta-analysis showed a diagnostic odds ratio of 43.68 (95%CI 13.5-141.31) for predicting response to neoadjuvant chemotherapy with high heterogeneity and low methodological quality. CONCLUSIONS The overall scientific quality of included studies is insufficient; however, radiomics remains a promising technology for predicting treatment response, which might guide therapeutic decision-making and related to prognosis. Improvements in study design, validation, and open science needs to be made to demonstrate the generalizability of findings and to achieve clinical applications. Widespread application of RQS, pre-trained RQS scoring procedure, and modification of RQS in response to clinical needs are necessary. KEY POINTS • Limited radiomics studies were established in osteosarcoma with mean RQS of 20.4%, commonly due to unvalidated results, retrospective study design, and absence of open science. • Meta-analysis of radiomics studies predicting osteosarcoma response to neoadjuvant chemotherapy showed high diagnostic odds ratio 43.68, while high heterogeneity and low methodological quality were the main concerns. • A previously trained data extraction instrument allowed reaching moderate inter-rater agreement in RQS applications, while RQS still needs improvement to become a wide adaptive tool in reviews of radiomics studies, in routine self-check before manuscript submitting and in study design.
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Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200050, China
| | - Yangfan Hu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Liping Si
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200050, China
| | - Geng Jia
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Yue Xing
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Road, Huangpu District, Shanghai, 200025, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200050, China.
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Dercle L, Henry T, Carré A, Paragios N, Deutsch E, Robert C. Reinventing radiation therapy with machine learning and imaging bio-markers (radiomics): State-of-the-art, challenges and perspectives. Methods 2020; 188:44-60. [PMID: 32697964 DOI: 10.1016/j.ymeth.2020.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
Radiation therapy is a pivotal cancer treatment that has significantly progressed over the last decade due to numerous technological breakthroughs. Imaging is now playing a critical role on deployment of the clinical workflow, both for treatment planning and treatment delivery. Machine-learning analysis of predefined features extracted from medical images, i.e. radiomics, has emerged as a promising clinical tool for a wide range of clinical problems addressing drug development, clinical diagnosis, treatment selection and implementation as well as prognosis. Radiomics denotes a paradigm shift redefining medical images as a quantitative asset for data-driven precision medicine. The adoption of machine-learning in a clinical setting and in particular of radiomics features requires the selection of robust, representative and clinically interpretable biomarkers that are properly evaluated on a representative clinical data set. To be clinically relevant, radiomics must not only improve patients' management with great accuracy but also be reproducible and generalizable. Hence, this review explores the existing literature and exposes its potential technical caveats, such as the lack of quality control, standardization, sufficient sample size, type of data collection, and external validation. Based upon the analysis of 165 original research studies based on PET, CT-scan, and MRI, this review provides an overview of new concepts, and hypotheses generating findings that should be validated. In particular, it describes evolving research trends to enhance several clinical tasks such as prognostication, treatment planning, response assessment, prediction of recurrence/relapse, and prediction of toxicity. Perspectives regarding the implementation of an AI-based radiotherapy workflow are presented.
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Affiliation(s)
- Laurent Dercle
- Department of Radiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, USA
| | - Theophraste Henry
- Molecular Radiotherapy and Innovative Therapeutics, INSERM UMR1030, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France; Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alexandre Carré
- Molecular Radiotherapy and Innovative Therapeutics, INSERM UMR1030, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | | | - Eric Deutsch
- Molecular Radiotherapy and Innovative Therapeutics, INSERM UMR1030, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Charlotte Robert
- Molecular Radiotherapy and Innovative Therapeutics, INSERM UMR1030, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, France.
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Chen H, Liu J, Cheng Z, Lu X, Wang X, Lu M, Li S, Xiang Z, Zhou Q, Liu Z, Zhao Y. Development and external validation of an MRI-based radiomics nomogram for pretreatment prediction for early relapse in osteosarcoma: A retrospective multicenter study. Eur J Radiol 2020; 129:109066. [PMID: 32502729 DOI: 10.1016/j.ejrad.2020.109066] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE To develop and externally validate an MR-based radiomics nomogram from retrospective multicenter datasets for pretreatment prediction of early relapse (≤ 1 year) in osteosarcoma after surgical resection. METHODS This multicenter study retrospectively enrolled 93 patients (training cohort: 62 patients from four hospitals; validation cohort: 31 patients from two hospitals) with clinicopathologically confirmed osteosarcoma who received neoadjuvant chemotherapy and surgical resection at six hospitals between January 2009 and October 2017. Radiomics features were extracted from contrast-enhanced fat-suppressed T1-weighted (CE FS T1-w) images. Least absolute shrinkage and selection operator (LASSO) regression was applied for feature selection and radiomics signature construction. The radiomics nomogram that incorporated the radiomics signature and subjective MRI-assessed candidate predictors was developed to predict early relapse with a multivariate logistic regression model in the training cohort and validated in the external validation cohort. The performance of the nomogram was assessed by its discrimination, calibration, and clinical usefulness. RESULTS The radiomics signature comprised six selected features and achieved favorable prediction efficacy. The radiomics nomogram incorporating the radiomics signature and subjective MRI-assessed candidate predictors (joint invasion and perivascular involvement) from the multicenter datasets achieved better discrimination in the training cohort (C-index:0.907, 95 % CI: 0.838-0.977) and external validation cohort (C-index: 0.811, 95 % CI: 0.653-0.970), and good calibration. Decision curve analysis suggested that the combined nomogram was clinically useful. CONCLUSION The proposed MRI-based radiomics nomogram could provide a non-invasive tool to predict early relapse of osteosarcoma, which has the potential to improve personalized pretreatment management of osteosarcoma.
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Affiliation(s)
- Haimei Chen
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Jin Liu
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Zixuan Cheng
- Department of Radiology, Guangzhou Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080,China.
| | - Xing Lu
- Sigma Technologies Inc, San Diego, CA 92130, United States.
| | - Xiaohong Wang
- Department of Radiology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, China.
| | - Ming Lu
- Department of Oncology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics, Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Shaolin Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong 519000, China.
| | - Zhiming Xiang
- Department of Radiology, Panyu Central Hospital of Guangzhou, Guangzhou, Guangdong 511400, China.
| | - Quan Zhou
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
| | - Zaiyi Liu
- Department of Radiology, Guangzhou Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080,China.
| | - Yinghua Zhao
- Department of Radiology, The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics. Guangdong Province), Guangzhou, Guangdong 510630, China.
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Zhang S, Ding L, Gao F, Fan H. Long non-coding RNA DSCAM-AS1 upregulates USP47 expression through sponging miR-101-3p to accelerate osteosarcoma progression. Biochem Cell Biol 2020; 98:600-611. [PMID: 32379981 DOI: 10.1139/bcb-2020-0031] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Osteosarcoma (OS) originating from mesenchyme is one of the most common invasive tumors of bone, and has an extremely high mortality rate. Previous studies have reported that long non-coding RNAs (lncRNAs) play essential roles in the tumorigenesis and progression of a multitude of human cancers. The lncRNA DSCAM-AS1 has been reported to be an oncogenic gene in many cancers. However, the roles and regulatory mechanisms of DSCAM-AS1 in OS have not been deeply investigated. In this study, our findings prove that DSCAM-AS1 is highly expressed in OS cells. Knockdown of DSCAM-AS1 suppressed cell proliferation, migration, and invasiveness, and induced cell apoptosis in OS. Additionally, knockdown of DSCAM-AS1 inactivated the Wnt-β-catenin signaling pathway. Moreover, research into its molecular mechanisms confirmed that DSCAM-AS1 functions as a sponge for miR-101-3p, and that ubiquitin-specific peptidase 47 (USP47) is a target gene of miR-101-3p. Furthermore, a negative relationship between miR-101-3p and DSCAM-AS1 or USP47 was discovered. The results from our rescue assays suggest that DSCAM-AS1 regulates the progression of OS through binding with miR-101-3p to control the expression of USP47. Finally, we discovered that AKT-mTOR signaling pathway mediates the activity of DSCAM-AS1 in OS. Taken together, our results show that DSCAM-AS1 accelerates the progression of OS via the miR-101-3p-USP47 axis, which could present a new potential therapeutic treatment for OS.
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Affiliation(s)
- Shanyong Zhang
- Department of Spine Surgery, The Second Hospital of Jilin University, Changchun 130000, Jilin, P.R. China
| | - Lei Ding
- Department of Rehabilitation, The Second Hospital of Jilin University, Changchun 130000, Jilin, P.R. China
| | - Feng Gao
- Department of Traumatic Orthopedics, The Second Hospital of Jilin University, Changchun 130000, Jilin, P.R. China
| | - Hongwu Fan
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130031, Jilin, P.R. China
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Zou M, Pan Y, Huang W, Zhang T, Escobar D, Wang X, Jiang Y, She X, Lv G, Li J. A four-factor immune risk score signature predicts the clinical outcome of patients with spinal chordoma. Clin Transl Med 2020; 10:224-237. [PMID: 32508056 PMCID: PMC7240847 DOI: 10.1002/ctm2.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 02/27/2020] [Accepted: 02/27/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Currently, the measurement of immune cells in previous studies is usually subjective, and no immune-based prognostic model has been established for chordoma. In this study, we sought to simultaneously measure tumor-infiltrating lymphocyte (TIL) subtypes in chordoma samples using an objective method and develop an immune risk score (IRS) model for survival prediction. METHODS Multiplexed quantitative immunofluorescence staining was used to determine the TIL levels in the tumoral and stromal subareas of 114 spinal chordoma specimens (54 in the training and 60 in the validation cohort) for programmed death-1 (PD-1), CD3, CD8, CD20 (where CD is cluster of differentiation), and FOXP3. Flow cytometry was performed to validate the immunofluorescence assay for lymphocyte measurement on an additional five fresh chordoma specimens. Subsequently, the IRS model was built using the least absolute shrinkage and selection operator (LASSO) Cox regression method. RESULTS Flow cytometry and quantitative immunofluorescence showed similar lymphocytic percentages and TIL subpopulation proportions in the fresh tumor specimens. With the training data, the LASSO model identified four immune features for IRS construction: tumoral FOXP3, tumoral PD-1, stromal FOXP3, and stromal CD8. In both cohorts, a high IRS was significantly associated with tumoral programmed cell death-1 ligand 1 expression, Enneking inappropriate tumor resection, and surrounding muscle invasion by tumor. Multivariate Cox regression and stratified analysis in the two cohorts revealed that the IRS was an independent predictor and could effectively separate patients with similar Enneking staging into different risk subgroups, with significantly different survival rates. Further receiver operating characteristic analysis found that the IRS classifier had a better prognostic value than the traditional clinicopathological factors and compensated for the deficiency of Enneking staging for outcome prediction. More importantly, a nomogram based on the IRS and clinical predictors showed adequate performance in estimating disease recurrence and survival of patients. CONCLUSIONS These data support the use of the IRS signature as a reliable prognostic tool in spinal chordoma and may facilitate individualized therapy decision making for patients.
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Affiliation(s)
- Ming‐Xiang Zou
- Department of Spine SurgeryThe First Affiliated HospitalUniversity of South ChinaHengyangChina
- Department of Spine SurgeryThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Yue Pan
- Department of Spine SurgeryThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Wei Huang
- Institute of Precision MedicineXiangya HospitalCentral South UniversityChangshaChina
| | - Tao‐Lan Zhang
- Department of Cancer BiologyCollege of Medicine & Life SciencesUniversity of ToledoToledoOhio
| | - David Escobar
- Department of Cancer BiologyCollege of Medicine & Life SciencesUniversity of ToledoToledoOhio
| | - Xiao‐Bin Wang
- Department of Spine SurgeryThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Yi Jiang
- Department of PathologyThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Xiao‐Ling She
- Department of PathologyThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Guo‐Hua Lv
- Department of Spine SurgeryThe Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Jing Li
- Department of Spine SurgeryThe Second Xiangya HospitalCentral South UniversityChangshaChina
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