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Trojani V, Bassi MC, Verzellesi L, Bertolini M. Impact of Preprocessing Parameters in Medical Imaging-Based Radiomic Studies: A Systematic Review. Cancers (Basel) 2024; 16:2668. [PMID: 39123396 PMCID: PMC11311340 DOI: 10.3390/cancers16152668] [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: 06/21/2024] [Revised: 07/16/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Lately, radiomic studies featuring the development of a signature to use in prediction models in diagnosis or prognosis outcomes have been increasingly published. While the results are shown to be promising, these studies still have many pitfalls and limitations. One of the main issues of these studies is that radiomic features depend on how the images are preprocessed before their computation. Since, in widely known and used software for radiomic features calculation, it is possible to set these preprocessing parameters before the calculation of the radiomic feature, there are ongoing studies assessing the stability and repeatability of radiomic features to find the most suitable preprocessing parameters for every used imaging modality. MATERIALS AND METHODS We performed a comprehensive literature search using four electronic databases: PubMed, Cochrane Library, Embase, and Scopus. Mesh terms and free text were modeled in search strategies for databases. The inclusion criteria were studies where preprocessing parameters' influence on feature values and model predictions was addressed. Records lacking information on image acquisition parameters were excluded, and any eligible studies with full-text versions were included in the review process, while conference proceedings and monographs were disregarded. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool to investigate the risk of bias. We synthesized our data in a table divided by the imaging modalities subgroups. RESULTS After applying the inclusion and exclusion criteria, we selected 43 works. This review examines the impact of preprocessing parameters on the reproducibility and reliability of radiomic features extracted from multimodality imaging (CT, MRI, CBCT, and PET/CT). Standardized preprocessing is crucial for consistent radiomic feature extraction. Key preprocessing steps include voxel resampling, normalization, and discretization, which influence feature robustness and reproducibility. In total, 44% of the included works studied the effects of an isotropic voxel resampling, and most studies opted to employ a discretization strategy. From 2021, several studies started selecting the best set of preprocessing parameters based on models' best performance. As for comparison metrics, ICC was the most used in MRI studies in 58% of the screened works. CONCLUSIONS From our work, we highlighted the need to harmonize the use of preprocessing parameters and their values, especially in light of future studies of prospective studies, which are still lacking in the current literature.
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Affiliation(s)
- Valeria Trojani
- Medical Physics, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy; (L.V.); (M.B.)
| | | | - Laura Verzellesi
- Medical Physics, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy; (L.V.); (M.B.)
| | - Marco Bertolini
- Medical Physics, Azienda USL-IRCCS, 42123 Reggio Emilia, Italy; (L.V.); (M.B.)
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Lin S, Gao M, Yang Z, Yu R, Dai Z, Jiang C, Yao Y, Xu T, Chen J, Huang K, Lin D. CT-Based Radiomics Models for Differentiation of Benign and Malignant Thyroid Nodules: A Multicenter Development and Validation Study. AJR Am J Roentgenol 2024; 223:e2431077. [PMID: 38691415 DOI: 10.2214/ajr.24.31077] [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] [Indexed: 05/03/2024]
Abstract
BACKGROUND. CT is increasingly detecting thyroid nodules. Prior studies indicated a potential role of CT-based radiomics models in characterizing thyroid nodules, although these studies lacked external validation. OBJECTIVE. The purpose of this study was to develop and validate a CT-based radiomics model for the differentiation of benign and malignant thyroid nodules. METHODS. This retrospective study included 378 patients (mean age, 46.3 ± 13.9 [SD] years; 86 men, 292 women) with 408 resected thyroid nodules (145 benign, 263 malignant) from two centers (center 1: 293 nodules, January 2018 to December 2022; center 2: 115 nodules, January 2020 to December 2022) who underwent preoperative multiphase neck CT (noncontrast, arterial, and venous phases). Nodules from center 1 were divided into training (n = 206) and internal validation (n = 87) sets; all nodules from center 2 formed an external validation set. Radiologists assessed nodules for morphologic CT features. Nodules were manually segmented on all phases, and radiomic features were extracted. Conventional (clinical and morphologic CT), noncontrast CT radiomics, arterial phase CT radiomics, venous phase CT radiomics, multiphase CT radiomics, and combined (clinical, morphologic CT, and multiphase CT radiomics) models were established using feature selection methods and evaluated by ROC curve analysis, calibration-curve analysis, and decision-curve analysis. RESULTS. The combined model included patient age, three morphologic features (cystic change, "edge interruption" sign, abnormal cervical lymph nodes), and 28 radiomic features (from all three phases). In the external validation set, the combined model had an AUC of 0.923, and, at an optimal threshold derived in the training set, sensitivity of 84.0%, specificity of 94.1%, and accuracy of 87.0%. In the external validation set, the AUC was significantly higher for the combined model than for the conventional model (0.827), noncontrast CT radiomics model (0.847), arterial phase CT radiomics model (0.826), venous phase CT radiomics model (0.773), and multiphase CT radiomics model (0.824) (all p < .05). In the external validation set, the calibration curves indicated the lowest (i.e., best) Brier score for the combined model; in the decision-curve analysis, the combined model had the highest net benefit for most of the range of threshold probabilities. CONCLUSION. A combined model incorporating clinical, morphologic CT, and multiphase CT radiomics features exhibited robust performance in differentiating benign and malignant thyroid nodules. CLINICAL IMPACT. The combined radiomics model may help guide further management for thyroid nodules detected on CT.
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Affiliation(s)
- Shaofan Lin
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Ming Gao
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zehong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Ruihuan Yu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zhuozhi Dai
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Chuling Jiang
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Yubin Yao
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Tingting Xu
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Jiali Chen
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Kainan Huang
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
| | - Daiying Lin
- Department of Radiology, Shantou Central Hospital, No. 114 Waima Rd, Shantou 515031, People's Republic of China
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van der Reijd DJ, Guerendel C, Staal FCR, Busard MP, De Oliveira Taveira M, Klompenhouwer EG, Kuhlmann KFD, Moelker A, Verhoef C, Starmans MPA, Lambregts DMJ, Beets-Tan RGH, Benson S, Maas M. Independent validation of CT radiomics models in colorectal liver metastases: predicting local tumour progression after ablation. Eur Radiol 2024; 34:3635-3643. [PMID: 37987835 PMCID: PMC11166748 DOI: 10.1007/s00330-023-10417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/07/2023] [Accepted: 09/10/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES Independent internal and external validation of three previously published CT-based radiomics models to predict local tumor progression (LTP) after thermal ablation of colorectal liver metastases (CRLM). MATERIALS AND METHODS Patients with CRLM treated with thermal ablation were collected from two institutions to collect a new independent internal and external validation cohort. Ablation zones (AZ) were delineated on portal venous phase CT 2-8 weeks post-ablation. Radiomics features were extracted from the AZ and a 10 mm peri-ablational rim (PAR) of liver parenchyma around the AZ. Three previously published prediction models (clinical, radiomics, combined) were tested without retraining. LTP was defined as new tumor foci appearing next to the AZ up to 24 months post-ablation. RESULTS The internal cohort included 39 patients with 68 CRLM and the external cohort 52 patients with 78 CRLM. 34/146 CRLM developed LTP after a median follow-up of 24 months (range 5-139). The median time to LTP was 8 months (range 2-22). The combined clinical-radiomics model yielded a c-statistic of 0.47 (95%CI 0.30-0.64) in the internal cohort and 0.50 (95%CI 0.38-0.62) in the external cohort, compared to 0.78 (95%CI 0.65-0.87) in the previously published original cohort. The radiomics model yielded c-statistics of 0.46 (95%CI 0.29-0.63) and 0.39 (95%CI 0.28-0.52), and the clinical model 0.51 (95%CI 0.34-0.68) and 0.51 (95%CI 0.39-0.63) in the internal and external cohort, respectively. CONCLUSION The previously published results for prediction of LTP after thermal ablation of CRLM using clinical and radiomics models were not reproducible in independent internal and external validation. CLINICAL RELEVANCE STATEMENT Local tumour progression after thermal ablation of CRLM cannot yet be predicted with the use of CT radiomics of the ablation zone and peri-ablational rim. These results underline the importance of validation of radiomics results to test for reproducibility in independent cohorts. KEY POINTS • Previous research suggests CT radiomics models have the potential to predict local tumour progression after thermal ablation in colorectal liver metastases, but independent validation is lacking. • In internal and external validation, the previously published models were not able to predict local tumour progression after ablation. • Radiomics prediction models should be investigated in independent validation cohorts to check for reproducibility.
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Affiliation(s)
- Denise J van der Reijd
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Corentin Guerendel
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Femke C R Staal
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Milou P Busard
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Mateus De Oliveira Taveira
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Elisabeth G Klompenhouwer
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Koert F D Kuhlmann
- Department of Surgery, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Adriaan Moelker
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Hospital Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, University Hospital Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Martijn P A Starmans
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Hospital Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Doenja M J Lambregts
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Regina G H Beets-Tan
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
- Institute of Regional Health Research, University of Southern Denmark, Campusvej 55, DK 5230, Odense M, Denmark
| | - Sean Benson
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Monique Maas
- Department of Radiology, Antoni Van Leeuwenhoek - The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- GROW School for Oncology and Reproduction, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.
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Zhong J, Wu Z, Wang L, Chen Y, Xia Y, Wang L, Li J, Lu W, Shi X, Feng J, Dong H, Zhang H, Yao W. Impacts of Adaptive Statistical Iterative Reconstruction-V and Deep Learning Image Reconstruction Algorithms on Robustness of CT Radiomics Features: Opportunity for Minimizing Radiomics Variability Among Scans of Different Dose Levels. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:123-133. [PMID: 38343265 DOI: 10.1007/s10278-023-00901-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 03/02/2024]
Abstract
This study aims to investigate the influence of adaptive statistical iterative reconstruction-V (ASIR-V) and deep learning image reconstruction (DLIR) on CT radiomics feature robustness. A standardized phantom was scanned under single-energy CT (SECT) and dual-energy CT (DECT) modes at standard and low (20 and 10 mGy) dose levels. Images of SECT 120 kVp and corresponding DECT 120 kVp-like virtual monochromatic images were generated with filtered back-projection (FBP), ASIR-V at 40% (AV-40) and 100% (AV-100) blending levels, and DLIR algorithm at low (DLIR-L), medium (DLIR-M), and high (DLIR-H) strength levels. Ninety-four features were extracted via Pyradiomics. Reproducibility of features was calculated between standard and low dose levels, between reconstruction algorithms in reference to FBP images, and within scan mode, using intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC). The average percentage of features with ICC > 0.90 and CCC > 0.90 between the two dose levels was 21.28% and 20.75% in AV-40 images, and 39.90% and 35.11% in AV-100 images, respectively, and increased from 15.43 to 45.22% and from 15.43 to 44.15% with an increasing strength level of DLIR. The average percentage of features with ICC > 0.90 and CCC > 0.90 in reference to FBP images was 26.07% and 25.80% in AV-40 images, and 18.88% and 18.62% in AV-100 images, respectively, and decreased from 27.93 to 17.82% and from 27.66 to 17.29% with an increasing strength level of DLIR. DLIR and ASIR-V algorithms showed low reproducibility in reference to FBP images, while the high-strength DLIR algorithm provides an opportunity for minimizing radiomics variability due to dose reduction.
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Affiliation(s)
- Jingyu Zhong
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Zhiyuan Wu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lingyun Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yong Chen
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yihan Xia
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lan Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jianying Li
- Computed Tomography Research Center, GE Healthcare, Beijing, 100176, China
| | - Wei Lu
- Computed Tomography Research Center, GE Healthcare, Shanghai, 201203, China
| | - Xiaomeng Shi
- Department of Materials, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Jianxing Feng
- Haohua Technology Co., Ltd., Shanghai, 201100, China
| | - Haipeng Dong
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Huan Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Weiwu Yao
- Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
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Singh Y, Kelm ZS, Faghani S, Erickson D, Yalon T, Bancos I, Erickson BJ. Deep learning approach for differentiating indeterminate adrenal masses using CT imaging. Abdom Radiol (NY) 2023; 48:3189-3194. [PMID: 37369921 DOI: 10.1007/s00261-023-03988-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Distinguishing stage 1-2 adrenocortical carcinoma (ACC) and large, lipid poor adrenal adenoma (LPAA) via imaging is challenging due to overlapping imaging characteristics. This study investigated the ability of deep learning to distinguish ACC and LPAA on single time-point CT images. METHODS Retrospective cohort study from 1994 to 2022. Imaging studies of patients with adrenal masses who had available adequate CT studies and histology as the reference standard by method of adrenal biopsy and/or adrenalectomy were included as well as four patients with LPAA determined by stability or regression on follow-up imaging. Forty-eight (48) subjects with pathology-proven, stage 1-2 ACC and 43 subjects with adrenal adenoma >3 cm in size demonstrating a mean non-contrast CT attenuation > 20 Hounsfield Units centrally were included. We used annotated single time-point contrast-enhanced CT images of these adrenal masses as input to a 3D Densenet121 model for classifying as ACC or LPAA with five-fold cross-validation. For each fold, two checkpoints were reported, highest accuracy with highest sensitivity (accuracy focused) and highest sensitivity with the highest accuracy (sensitivity focused). RESULTS We trained a deep learning model (3D Densenet121) to predict ACC versus LPAA. The sensitivity-focused model achieved mean accuracy: 87.2% and mean sensitivity: 100%. The accuracy-focused model achieved mean accuracy: 91% and mean sensitivity: 96%. CONCLUSION Deep learning demonstrates promising results distinguishing between ACC and large LPAA using single time-point CT images. Before being widely adopted in clinical practice, multicentric and external validation are needed.
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Affiliation(s)
- Yashbir Singh
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Zachary S Kelm
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Dana Erickson
- Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Tal Yalon
- Department of General Surgery, Mayo Clinic, La Crosse, WI, USA
| | - Irina Bancos
- Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
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Xue G, Liu H, Cai X, Zhang Z, Zhang S, Liu L, Hu B, Wang G. Impact of deep learning image reconstruction algorithms on CT radiomic features in patients with liver tumors. Front Oncol 2023; 13:1167745. [PMID: 37091167 PMCID: PMC10113560 DOI: 10.3389/fonc.2023.1167745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
ObjectiveTo evaluate the impact of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASIR-V) on abdominal CT radiomic features acquired in portal venous phase in liver tumor patients.MethodsSixty patients with liver tumors who underwent contrast-enhanced abdominal CT were retrospectively enrolled. Six groups including filtered back projection (FBP), ASIR-V (30%, 70%) and DLIR at low (DLIR-L), medium (DLIR-M and high (DLIR-H), were reconstructed using portal venous phase data. CT-based radiomic features (first-order, texture and wavelet features) were extracted from 2D and 3D liver tumors, peritumor and liver parenchyma. All features were analyzed for comparison. P < 0.05 indicated statistically different. The consistency of 3D lesion feature extraction was assessed by calculating intraclass correlation coefficient (ICC).ResultsDifferent reconstruction algorithms influenced most radiomic features. The percentages of first-order, texture and wavelet features without statistical difference among 2D and 3D lesions, peritumor and liver parenchyma for all six groups were 27.78% (5/18), 5.33% (4/75) and 5.56% (1/18), respectively (all p > 0.05), and they decreased while the level of reconstruction strengthened for both ASIR-V and DLIR. Compared with FBP, the features of ASIR-V30% and 70% without statistical difference decreased from 71.31% to 23.95%, and DLIR-L, DLIR-M, and DLIR-H decreased from 31.65% to 27.11% and 23.73%. Among texture features, unaffected features of peritumor were larger than those of lesions and liver parenchyma, and unaffected 3D lesions features were larger than those of 2D lesions. The consistency of 3D lesion first-order features was excellent, with intra- and inter-observer ICCs ranging from 0.891 to 0.999 and 0.880 to 0.998.ConclusionsBoth ASIR-V and DLIR algorithms with different strengths influenced the radiomic features of abdominal CT images in portal venous phase, and the influences aggravated as reconstruction strength increased.
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Affiliation(s)
- Gongbo Xue
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, China
- Graduate School, Dalian Medical University, Dalian, China
| | - Hongyan Liu
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, China
| | - Xiaoyi Cai
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, China
- Graduate School, Dalian Medical University, Dalian, China
| | - Zhen Zhang
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, China
| | - Shuai Zhang
- CT Imaging Research Center, GE Healthcare China, Shanghai, China
| | - Ling Liu
- CT Imaging Research Center, GE Healthcare China, Shanghai, China
| | - Bin Hu
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
- *Correspondence: Guohua Wang, ; Bin Hu,
| | - Guohua Wang
- Department of Radiology, Qingdao Municipal Hospital, Qingdao, China
- *Correspondence: Guohua Wang, ; Bin Hu,
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Guo W, Liu J, Wang X, Yuan H. Predicting the Risk of Thymic Tumors Using Texture Analysis of Contrast-Enhanced Chest Computed Tomography. J Comput Assist Tomogr 2023:00004728-990000000-00164. [PMID: 36944121 DOI: 10.1097/rct.0000000000001467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This study aimed to explore the value of contrast-enhanced computed tomography texture features for predicting the risk of malignant thymic epithelial tumor. METHODS Data of 97 patients with pathologically confirmed thymic epithelial tumors treated at in our hospital from March 2015 to October 2021 were retrospectively analyzed. Based on the World Health Organization classification of thymic epithelial tumors, patients were divided into a high-risk group (types B2, B3, and C; n = 45) and a low-risk group (types A, AB, and B1; n = 52). Texture analysis was performed using a first-order, gray-level histogram method. Six features were evaluated: mean, variance, skewness, kurtosis, energy, and entropy. The association between contrast-enhanced computed tomography texture features and the risk of malignancy in thymic epithelial tumors was analyzed. The predictive thresholds of predictive texture features were determined by receiver operating characteristics analysis. RESULTS The mean, skewness, and entropy were significantly greater in the high-risk group than in the low-risk group (P < 0.05); however, variance, kurtosis, and energy were comparable in the two groups (P > 0.05). The area under curve of mean, skewness, and entropy was 0.670, 0.760, and 0.880, respectively. The optimal cutoff value of entropy for predicting risk of malignancy was 7.74, with sensitivity, specificity, and accuracy of 80.0%, 80.0%, and 75%, respectively. CONCLUSIONS Contrast-enhanced computed tomography texture features, especially entropy, may be a useful tool to predict the risk of malignancy in thymic epithelial tumors.
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Affiliation(s)
- Wei Guo
- From the Department of Radiology, Peking University Third Hospital, Beijing
| | - Jianfang Liu
- Department of Radiology, Union Hospital of Fujian Medical University, Fuzhou, PR China
| | - Xiaohua Wang
- From the Department of Radiology, Peking University Third Hospital, Beijing
| | - Huishu Yuan
- From the Department of Radiology, Peking University Third Hospital, Beijing
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Li JP, Zhao S, Jiang HJ, Jiang H, Zhang LH, Shi ZX, Fan TT, Wang S. Quantitative dual-energy computed tomography texture analysis predicts the response of primary small hepatocellular carcinoma to radiofrequency ablation. Hepatobiliary Pancreat Dis Int 2022; 21:569-576. [PMID: 35729000 DOI: 10.1016/j.hbpd.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/31/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Radiofrequency ablation (RFA) is one of the effective therapeutic modalities in patients with hepatocellular carcinoma (HCC). However, there is no proper method to evaluate the HCC response to RFA. This study aimed to establish and validate a clinical prediction model based on dual-energy computed tomography (DECT) quantitative-imaging parameters, clinical variables, and CT texture parameters. METHODS We enrolled 63 patients with small HCC. Two to four weeks after RFA, we performed DECT scanning to obtain DECT-quantitative parameters and to record the patients' clinical baseline variables. DECT images were manually segmented, and 56 CT texture features were extracted. We used LASSO algorithm for feature selection and data dimensionality reduction; logistic regression analysis was used to build a clinical model with clinical variables and DECT-quantitative parameters; we then added texture features to build a clinical-texture model based on clinical model. RESULTS A total of six optimal CT texture analysis (CTTA) features were selected, which were statistically different between patients with or without tumor progression (P < 0.05). When clinical variables and DECT-quantitative parameters were included, the clinical models showed that albumin-bilirubin grade (ALBI) [odds ratio (OR) = 2.77, 95% confidence interval (CI): 1.35-6.65, P = 0.010], λAP (40-100 keV) (OR = 3.21, 95% CI: 3.16-5.65, P = 0.045) and ICAP (OR = 1.25, 95% CI: 1.01-1.62, P = 0.028) were associated with tumor progression, while the clinical-texture models showed that ALBI (OR = 2.40, 95% CI: 1.19-5.68, P = 0.024), λAP (40-100 keV) (OR = 1.43, 95% CI: 1.10-2.07, P = 0.019), and CTTA-score (OR = 2.98, 95% CI: 1.68-6.66, P = 0.001) were independent risk factors for tumor progression. The clinical model, clinical-texture model, and CTTA-score all performed well in predicting tumor progression within 12 months after RFA (AUC = 0.917, 0.962, and 0.906, respectively), and the C-indexes of the clinical and clinical-texture models were 0.917 and 0.957, respectively. CONCLUSIONS DECT-quantitative parameters, CTTA, and clinical variables were helpful in predicting HCC progression after RFA. The constructed clinical prediction model can provide early warning of potential tumor progression risk for patients after RFA.
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Affiliation(s)
- Jin-Ping Li
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Sheng Zhao
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Hui-Jie Jiang
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
| | - Hao Jiang
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Lin-Han Zhang
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China; Department of Nuclear Medicine, the First Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Zhong-Xing Shi
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Ting-Ting Fan
- Department of Radiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Song Wang
- Department of Radiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
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Wang Q, Xu S, Zhang G, Zhang X, Gu J, Yang S, Zeng M, Zhang Z. Applying a CT texture analysis model trained with deep-learning reconstruction images to iterative reconstruction images in pulmonary nodule diagnosis. J Appl Clin Med Phys 2022; 23:e13759. [PMID: 35998185 DOI: 10.1002/acm2.13759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/26/2022] [Accepted: 08/03/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the feasibility and accuracy of applying a computed tomography (CT) texture analysis model trained with deep-learning reconstruction images to iterative reconstruction images for classifying pulmonary nodules. MATERIALS AND METHODS CT images of 102 patients, with a total of 118 pulmonary nodules (52 benign, 66 malignant) were retrospectively reconstructed with a deep-learning reconstruction (artificial intelligence iterative reconstruction [AIIR]) and a hybrid iterative reconstruction (HIR) technique. The AIIR data were divided into a training (n = 96) and a validation set (n = 22), and the HIR data were set as the test set (n = 118). Extracted texture features were compared using the Mann-Whitney U test and t-test. The diagnostic performance of the classification model was analyzed with the receiver operating characteristic curve (ROC), the area under ROC (AUC), sensitivity, specificity, and accuracy. RESULTS Among the obtained 68 texture features, 51 (75.0%) were not influenced by the change of reconstruction algorithm (p > 0.05). Forty-four features were significantly different between benign and malignant nodules (p < 0.05) for the AIIR dataset, which were selected to build the classification model. The accuracy and AUC of the classification model were 92.3% and 0.91 (95% confidence interval [CI], 0.74-0.90) with the validation set, which were 80.0% and 0.80 (95% CI, 0.68-0.86) with the test set. CONCLUSION With the CT texture analysis model trained with deep-learning reconstruction (AIIR) images showing favorable diagnostic accuracy in discriminating benign and malignant pulmonary nodules, it also has certain applicability to the iterative reconstruction (HIR) images.
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Affiliation(s)
- Qingle Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shijie Xu
- Shanghai United Imaging Healthcare, Shanghai, China
| | - Guozhi Zhang
- Shanghai United Imaging Healthcare, Shanghai, China
| | - Xingwei Zhang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Junying Gu
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shuyi Yang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhiyong Zhang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Medical Imaging, Shanghai, China.,Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai, China
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10
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Doillon M, Durot C, Pluchart C, Marcus C, Djelouah M, Carsin-Vu A. Response to Induction Therapy in Pediatric Hodgkin's Lymphoma: Performance of First-Order Texture Parameters of CT Images. J Belg Soc Radiol 2022; 106:46. [PMID: 35647484 PMCID: PMC9104423 DOI: 10.5334/jbsr.2752] [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: 01/04/2022] [Accepted: 04/22/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives The aim of this study was to examine whether texture analysis features on pretreatment contrast-enhanced CT images could predict adequate response (AR) or inadequate response (IR) after two cycles of chemotherapy in pediatric Hodgkin's lymphoma (PHL). Materials and methods This retrospective single-center study included 32 children and adolescents with HL. Texture analysis was independently performed by two radiologists using pretreatment CT scans. The mean gray level, standard deviation, entropy, kurtosis, and skewness were derived from pixel distribution histograms before and after spatial filtration ranging from two (fine texture) to six (coarse texture). Interobserver reliability was studied using interobserver correlation coefficients (ICCs) to select texture parameters. Relationships between early response assessment (ERA) to induction therapy and associated factors were studied using Student's t-tests and a lasso penalized logistic regression analysis. Results Of the 32 patients, IR was observed in 13 and AR in 19. Inter-reader agreement was good to excellent (ICC > 0.75) for all parameters except skewness and kurtosis without filtration and at spatial scale filtration (SSF) = 2. These parameters were excluded from the analysis. The t-test identified only entropy at SSF = 2 (p value = 0.039) as a potential predictor of ERA. No parameters were significantly associated with ERA, according to a lasso penalized logistic regression. Conclusion No textural parameters were identified as predictors of ERA after two cycles of chemotherapy in PHL.
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Affiliation(s)
- Margaux Doillon
- Department of Radiology, American Memorial Hospital, 47 rue Cognacq-jay, FR
| | - Carole Durot
- Department of Radiology, American Memorial Hospital, 47 rue Cognacq-jay, FR
| | - Claire Pluchart
- Department of Oncopediatrics, American Memorial Hospital, 47 rue Cognacq-jay, FR
| | - Claude Marcus
- Department of Radiology, American Memorial Hospital, 47 rue Cognac q-jay, FR
| | - Manel Djelouah
- Department of Radiology, American Memorial Hospital, 47 rue Cognacq-jay, FR
| | - Aline Carsin-Vu
- Department of Radiology, American Memorial Hospital, 47 rue Cognacq-jay, FR
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11
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CT Reconstruction Kernels and the Effect of Pre- and Post-Processing on the Reproducibility of Handcrafted Radiomic Features. J Pers Med 2022; 12:jpm12040553. [PMID: 35455668 PMCID: PMC9030848 DOI: 10.3390/jpm12040553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Handcrafted radiomics features (HRFs) are quantitative features extracted from medical images to decode biological information to improve clinical decision making. Despite the potential of the field, limitations have been identified. The most important identified limitation, currently, is the sensitivity of HRF to variations in image acquisition and reconstruction parameters. In this study, we investigated the use of Reconstruction Kernel Normalization (RKN) and ComBat harmonization to improve the reproducibility of HRFs across scans acquired with different reconstruction kernels. A set of phantom scans (n = 28) acquired on five different scanner models was analyzed. HRFs were extracted from the original scans, and scans were harmonized using the RKN method. ComBat harmonization was applied on both sets of HRFs. The reproducibility of HRFs was assessed using the concordance correlation coefficient. The difference in the number of reproducible HRFs in each scenario was assessed using McNemar’s test. The majority of HRFs were found to be sensitive to variations in the reconstruction kernels, and only six HRFs were found to be robust with respect to variations in reconstruction kernels. The use of RKN resulted in a significant increment in the number of reproducible HRFs in 19 out of the 67 investigated scenarios (28.4%), while the ComBat technique resulted in a significant increment in 36 (53.7%) scenarios. The combination of methods resulted in a significant increment in 53 (79.1%) scenarios compared to the HRFs extracted from original images. Since the benefit of applying the harmonization methods depended on the data being harmonized, reproducibility analysis is recommended before performing radiomics analysis. For future radiomics studies incorporating images acquired with similar image acquisition and reconstruction parameters, except for the reconstruction kernels, we recommend the systematic use of the pre- and post-processing approaches (respectively, RKN and ComBat).
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12
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Rinaldi L, Pezzotta F, Santaniello T, De Marco P, Bianchini L, Origgi D, Cremonesi M, Milani P, Mariani M, Botta F. HeLLePhant: A phantom mimicking non-small cell lung cancer for texture analysis in CT images. Phys Med 2022; 97:13-24. [PMID: 35334407 DOI: 10.1016/j.ejmp.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/01/2022] [Accepted: 03/14/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Phantoms mimicking human tissue heterogeneity and intensity are required to establish radiomic features robustness in Computed Tomography (CT) images. We developed inserts with two different techniques for the radiomic study of Non-Small Cell Lung Cancer (NSCLC) lesions. METHODS We developed two insert prototypes: two 3D-printed made of glycol-modified polyethylene terephthalate (PET-G), and nine with sodium polyacrylate plus iodinated contrast medium. The inserts were put in a handcraft phantom (HeLLePhant). We also analysed four materials of a commercial homogeneous phantom (Catphan® 424) and collected 29 NSCLC patients for comparison. All the CT acquisitions were performed with the same clinical protocol and scanner at 120kVp. The HeLLePhant phantom was scanned ten times in fixed condition at 120kVp and 100kVp for repeatability investigation. We extracted 153 radiomic features using Pyradiomics. To compare the features between phantoms and patients, we computed how many phantom features fell in the range between 10th and 90th percentile of the corresponding patient values. We deemed repeatable the features with a coefficient of variation (CV) less than or equal to 0.10. RESULTS The best similarity with the patients was obtained with the polyacrylate inserts (55.6-90.2%), the worst with Catphan (15.7-19.0%). For the PET-G inserts 35.3% and 36.6% of the features match the patient range. We found high repeatability for all the inserts of the HeLLePhant phantom (74.3-100% at 120kVp, 75.7-97.9% at 100kVp), and observed a texture dependency in repeatability. CONCLUSIONS Our study shows a promising way to construct heterogeneous inserts mimicking a target tissue for radiomic studies.
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Affiliation(s)
- Lisa Rinaldi
- Department of Physics, Università degli Studi di Pavia and INFN, via Bassi 6, 27100 Pavia, Italy; Radiation Research Unit, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy.
| | - Federico Pezzotta
- CIMaINa, Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Tommaso Santaniello
- CIMaINa, Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Paolo De Marco
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Linda Bianchini
- Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Daniela Origgi
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Marta Cremonesi
- Radiation Research Unit, IEO, European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
| | - Paolo Milani
- CIMaINa, Department of Physics, Università degli Studi di Milano, via Celoria 16, 20133, Milan, Italy
| | - Manuel Mariani
- Department of Physics, Università degli Studi di Pavia and INFN, via Bassi 6, 27100 Pavia, Italy
| | - Francesca Botta
- Medical Physics Unit, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141 Milan, Italy
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Deep learning reconstruction improves radiomics feature stability and discriminative power in abdominal CT imaging: a phantom study. Eur Radiol 2022; 32:4587-4595. [PMID: 35174400 PMCID: PMC9213380 DOI: 10.1007/s00330-022-08592-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/05/2022] [Accepted: 01/24/2022] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To compare image quality of deep learning reconstruction (AiCE) for radiomics feature extraction with filtered back projection (FBP), hybrid iterative reconstruction (AIDR 3D), and model-based iterative reconstruction (FIRST). METHODS Effects of image reconstruction on radiomics features were investigated using a phantom that realistically mimicked a 65-year-old patient's abdomen with hepatic metastases. The phantom was scanned at 18 doses from 0.2 to 4 mGy, with 20 repeated scans per dose. Images were reconstructed with FBP, AIDR 3D, FIRST, and AiCE. Ninety-three radiomics features were extracted from 24 regions of interest, which were evenly distributed across three tissue classes: normal liver, metastatic core, and metastatic rim. Features were analyzed in terms of their consistent characterization of tissues within the same image (intraclass correlation coefficient ≥ 0.75), discriminative power (Kruskal-Wallis test p value < 0.05), and repeatability (overall concordance correlation coefficient ≥ 0.75). RESULTS The median fraction of consistent features across all doses was 6%, 8%, 6%, and 22% with FBP, AIDR 3D, FIRST, and AiCE, respectively. Adequate discriminative power was achieved by 48%, 82%, 84%, and 92% of features, and 52%, 20%, 17%, and 39% of features were repeatable, respectively. Only 5% of features combined consistency, discriminative power, and repeatability with FBP, AIDR 3D, and FIRST versus 13% with AiCE at doses above 1 mGy and 17% at doses ≥ 3 mGy. AiCE was the only reconstruction technique that enabled extraction of higher-order features. CONCLUSIONS AiCE more than doubled the yield of radiomics features at doses typically used clinically. Inconsistent tissue characterization within CT images contributes significantly to the poor stability of radiomics features. KEY POINTS • Image quality of CT images reconstructed with filtered back projection and iterative methods is inadequate for the majority of radiomics features due to inconsistent tissue characterization, low discriminative power, or low repeatability. • Deep learning reconstruction enhances image quality for radiomics and more than doubled the feature yield at doses that are typically used in clinical CT imaging. • Image reconstruction algorithms can optimize image quality for more reliable quantification of tissues in CT images.
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Reproducibility of radiomic features in CT images of NSCLC patients: an integrative analysis on the impact of acquisition and reconstruction parameters. Eur Radiol Exp 2022; 6:2. [PMID: 35075539 PMCID: PMC8786992 DOI: 10.1186/s41747-021-00258-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We investigated to what extent tube voltage, scanner model, and reconstruction algorithm affect radiomic feature reproducibility in a single-institution retrospective database of computed tomography images of non-small-cell lung cancer patients. METHODS This study was approved by the Institutional Review Board (UID 2412). Images of 103 patients were considered, being acquired on either among two scanners, at 100 or 120 kVp. For each patient, images were reconstructed with six iterative blending levels, and 1414 features were extracted from each reconstruction. At univariate analysis, Wilcoxon-Mann-Whitney test was applied to evaluate feature differences within scanners and voltages, whereas the impact of the reconstruction was established with the overall concordance correlation coefficient (OCCC). A multivariable mixed model was also applied to investigate the independent contribution of each acquisition/reconstruction parameter. Univariate and multivariable analyses were combined to analyse feature behaviour. RESULTS Scanner model and voltage did not affect features significantly. The reconstruction blending level showed a significant impact at both univariate analysis (154/1414 features yielding an OCCC < 0.85) and multivariable analysis, with most features (1042/1414) revealing a systematic trend with the blending level (multiple comparisons adjusted p < 0.05). Reproducibility increased in association to image processing with smooth filters, nonetheless specific investigation in relation to clinical endpoints should be performed to ensure that textural information is not removed. CONCLUSIONS Combining univariate and multivariable models is allowed to identify features for which corrections may be applied to reduce the trend with the algorithm and increase reproducibility. Subsequent clustering may be applied to eliminate residual redundancy.
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15
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Iddins CJ, DiCarlo AL, Ervin MD, Herrera-Reyes E, Goans RE. Cutaneous and local radiation injuries. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:10.1088/1361-6498/ac241a. [PMID: 34488201 PMCID: PMC8785213 DOI: 10.1088/1361-6498/ac241a] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
The threat of a large-scale radiological or nuclear (R/N) incident looms in the present-day climate, as noted most recently in an editorial in Scientific American (March 2021). These large-scale incidents are infrequent but affect large numbers of people. Smaller-scale R/N incidents occur more often, affecting smaller numbers of people. There is more awareness of acute radiation syndrome (ARS) in the medical community; however, ionising radiation-induced injuries to the skin are much less understood. This article will provide an overview of radiation-induced injuries to the skin, deeper tissues, and organs. The history and nomenclature; types and causes of injuries; pathophysiology; evaluation and diagnosis; current medical management; and current research of the evaluation and management are presented. Cutaneous radiation injuries (CRI) or local radiation injuries (LRI) may lead to cutaneous radiation syndrome, a sub-syndrome of ARS. These injuries may occur from exposure to radioactive particles suspended in the environment (air, soil, water) after a nuclear detonation or an improvised nuclear detonation (IND), a nuclear power plant incident, or an encounter with a radioactive dispersal or exposure device. These incidents may also result in a radiation-combined injury; a chemical, thermal, or traumatic injury, with radiation exposure. Skin injuries from medical diagnostic and therapeutic imaging, medical misadministration of nuclear medicine or radiotherapy, occupational exposures (including research) to radioactive sources are more common but are not the focus of this manuscript. Diagnosis and evaluation of injuries are based on the scenario, clinical picture, and dosimetry, and may be assisted through advanced imaging techniques. Research-based multidisciplinary therapies, both in the laboratory and clinical trial environments, hold promise for future medical management. Great progress is being made in recognising the extent of injuries, understanding their pathophysiology, as well as diagnosis and management; however, research gaps still exist.
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Affiliation(s)
- Carol J Iddins
- Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States of America
| | - Andrea L DiCarlo
- Radiation and Nuclear Countermeasures Program (RNCP), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States of America
| | - Mark D Ervin
- Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States of America
| | | | - Ronald E Goans
- Radiation Emergency Assistance Center/Training Site (REAC/TS), Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, United States of America
- MJW Corporation, Buffalo, NY, United States of America
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Crimì F, Quaia E, Cabrelle G, Zanon C, Pepe A, Regazzo D, Tizianel I, Scaroni C, Ceccato F. Diagnostic Accuracy of CT Texture Analysis in Adrenal Masses: A Systematic Review. Int J Mol Sci 2022; 23:ijms23020637. [PMID: 35054823 PMCID: PMC8776161 DOI: 10.3390/ijms23020637] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 12/19/2022] Open
Abstract
Adrenal incidentalomas (AIs) are incidentally discovered adrenal neoplasms. Overt endocrine secretion (glucocorticoids, mineralocorticoids, and catecholamines) and malignancy (primary or metastatic disease) are assessed at baseline evaluation. Size, lipid content, and washout characterise benign AIs (respectively, <4 cm, <10 Hounsfield unit, and rapid release); nonetheless, 30% of adrenal lesions are not correctly indicated. Recently, image-based texture analysis from computed tomography (CT) may be useful to assess the behaviour of indeterminate adrenal lesions. We performed a systematic review to provide the state-of-the-art of texture analysis in patients with AI. We considered 9 papers (from 70 selected), with a median of 125 patients (range 20–356). Histological confirmation was the most used criteria to differentiate benign from the malignant adrenal mass. Unenhanced or contrast-enhanced data were available in all papers; TexRAD and PyRadiomics were the most used software. Four papers analysed the whole volume, and five considered a region of interest. Different texture features were reported, considering first- and second-order statistics. The pooled median area under the ROC curve in all studies was 0.85, depicting a high diagnostic accuracy, up to 93% in differentiating adrenal adenoma from adrenocortical carcinomas. Despite heterogeneous methodology, texture analysis is a promising diagnostic tool in the first assessment of patients with adrenal lesions.
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Affiliation(s)
- Filippo Crimì
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Institute of Radiology, University-Hospital of Padova, 35128 Padua, Italy
| | - Emilio Quaia
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Institute of Radiology, University-Hospital of Padova, 35128 Padua, Italy
| | - Giulio Cabrelle
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Institute of Radiology, University-Hospital of Padova, 35128 Padua, Italy
| | - Chiara Zanon
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Institute of Radiology, University-Hospital of Padova, 35128 Padua, Italy
| | - Alessia Pepe
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Institute of Radiology, University-Hospital of Padova, 35128 Padua, Italy
| | - Daniela Regazzo
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Endocrine Disease Unit, University-Hospital of Padova, 35128 Padua, Italy
| | - Irene Tizianel
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Endocrine Disease Unit, University-Hospital of Padova, 35128 Padua, Italy
| | - Carla Scaroni
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Endocrine Disease Unit, University-Hospital of Padova, 35128 Padua, Italy
| | - Filippo Ceccato
- Department of Medicine DIMED, University of Padova, 35128 Padua, Italy; (F.C.); (E.Q.); (G.C.); (C.Z.); (A.P.); (D.R.); (I.T.); (C.S.)
- Endocrine Disease Unit, University-Hospital of Padova, 35128 Padua, Italy
- Correspondence: ; Tel.: +39-049-8211323; Fax: +39-049-657391
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Magnuska ZA, Theek B, Darguzyte M, Palmowski M, Stickeler E, Schulz V, Kießling F. Influence of the Computer-Aided Decision Support System Design on Ultrasound-Based Breast Cancer Classification. Cancers (Basel) 2022; 14:277. [PMID: 35053441 PMCID: PMC8773857 DOI: 10.3390/cancers14020277] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 12/30/2021] [Indexed: 02/04/2023] Open
Abstract
Automation of medical data analysis is an important topic in modern cancer diagnostics, aiming at robust and reproducible workflows. Therefore, we used a dataset of breast US images (252 malignant and 253 benign cases) to realize and compare different strategies for CAD support in lesion detection and classification. Eight different datasets (including pre-processed and spatially augmented images) were prepared, and machine learning algorithms (i.e., Viola-Jones; YOLOv3) were trained for lesion detection. The radiomics signature (RS) was derived from detection boxes and compared with RS derived from manually obtained segments. Finally, the classification model was established and evaluated concerning accuracy, sensitivity, specificity, and area under the Receiver Operating Characteristic curve. After training on a dataset including logarithmic derivatives of US images, we found that YOLOv3 obtains better results in breast lesion detection (IoU: 0.544 ± 0.081; LE: 0.171 ± 0.009) than the Viola-Jones framework (IoU: 0.399 ± 0.054; LE: 0.096 ± 0.016). Interestingly, our findings show that the classification model trained with RS derived from detection boxes and the model based on the RS derived from a gold standard manual segmentation are comparable (p-value = 0.071). Thus, deriving radiomics signatures from the detection box is a promising technique for building a breast lesion classification model, and may reduce the need for the lesion segmentation step in the future design of CAD systems.
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Affiliation(s)
- Zuzanna Anna Magnuska
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (Z.A.M.); (B.T.); (M.D.); (V.S.)
| | - Benjamin Theek
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (Z.A.M.); (B.T.); (M.D.); (V.S.)
| | - Milita Darguzyte
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (Z.A.M.); (B.T.); (M.D.); (V.S.)
| | - Moritz Palmowski
- Radiologie Baden-Baden, Beethovenstraße 2, 76530 Baden-Baden, Germany;
| | - Elmar Stickeler
- Department of Obstetrics and Gynecology, University Clinic Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany;
- Comprehensive Diagnostic Center Aachen, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Volkmar Schulz
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (Z.A.M.); (B.T.); (M.D.); (V.S.)
- Comprehensive Diagnostic Center Aachen, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
- Physics Institute III B, RWTH Aachen University, 52074 Aachen, Germany
- Hyperion Hybrid Imaging Systems GmbH, 52074 Aachen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Am Fallturm 1, 28359 Bremen, Germany
| | - Fabian Kießling
- Institute for Experimental Molecular Imaging, Uniklinik RWTH Aachen and Helmholtz Institute for Biomedical Engineering, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany; (Z.A.M.); (B.T.); (M.D.); (V.S.)
- Comprehensive Diagnostic Center Aachen, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Am Fallturm 1, 28359 Bremen, Germany
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18
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Machine learning principles applied to CT radiomics to predict mucinous pancreatic cysts. Abdom Radiol (NY) 2022; 47:221-231. [PMID: 34636933 DOI: 10.1007/s00261-021-03289-0] [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: 06/02/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Current diagnostic and treatment modalities for pancreatic cysts (PCs) are invasive and are associated with patient morbidity. The purpose of this study is to develop and evaluate machine learning algorithms to delineate mucinous from non-mucinous PCs using non-invasive CT-based radiomics. METHODS A retrospective, single-institution analysis of patients with non-pseudocystic PCs, contrast-enhanced computed tomography scans within 1 year of resection, and available surgical pathology were included. A quantitative imaging software platform was used to extract radiomics. An extreme gradient boosting (XGBoost) machine learning algorithm was used to create mucinous classifiers using texture features only, or radiomic/radiologic and clinical combined models. Classifiers were compared using performance scoring metrics. Shapely additive explanation (SHAP) analyses were conducted to identify variables most important in model construction. RESULTS Overall, 99 patients and 103 PCs were included in the analyses. Eighty (78%) patients had mucinous PCs on surgical pathology. Using multiple fivefold cross validations, the texture features only and combined XGBoost mucinous classifiers demonstrated an area under the curve of 0.72 ± 0.14 and 0.73 ± 0.14, respectively. By SHAP analysis, root mean square, mean attenuation, and kurtosis were the most predictive features in the texture features only model. Root mean square, cyst location, and mean attenuation were the most predictive features in the combined model. CONCLUSION Machine learning principles can be applied to PC texture features to create a mucinous phenotype classifier. Model performance did not improve with the combined model. However, specific radiomic, radiologic, and clinical features most predictive in our models can be identified using SHAP analysis.
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19
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Albano D, Gatta R, Marini M, Rodella C, Camoni L, Dondi F, Giubbini R, Bertagna F. Role of 18F-FDG PET/CT Radiomics Features in the Differential Diagnosis of Solitary Pulmonary Nodules: Diagnostic Accuracy and Comparison between Two Different PET/CT Scanners. J Clin Med 2021; 10:jcm10215064. [PMID: 34768584 PMCID: PMC8584460 DOI: 10.3390/jcm10215064] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 12/21/2022] Open
Abstract
The aim of this retrospective study was to investigate the ability of 18 fluorine-fluorodeoxyglucose positron emission tomography/CT (18F-FDG-PET/CT) metrics and radiomics features (RFs) in predicting the final diagnosis of solitary pulmonary nodules (SPN). We retrospectively recruited 202 patients who underwent a 18F-FDG-PET/CT before any treatment in two PET scanners. After volumetric segmentation of each lung nodule, 8 PET metrics and 42 RFs were extracted. All the features were tested for significant differences between the two PET scanners. The performances of all features in predicting the nature of SPN were analyzed by testing three classes of final logistic regression predictive models: two were built/trained through exploiting the separate data from the two scanners, and the other joined the data together. One hundred and twenty-seven patients had a final diagnosis of malignancy, while 64 were of a benign nature. Comparing the two PET scanners, we found that all metabolic features and most of RFs were significantly different, despite the cross correlation being quite similar. For scanner 1, a combination between grey level co-occurrence matrix (GLCM), histogram, and grey-level zone length matrix (GLZLM) related features presented the best performances to predict the diagnosis; for scanner 2, it was GLCM and histogram-related features and metabolic tumour volume (MTV); and for scanner 1 + 2, it was histogram features, standardized uptake value (SUV) metrics, and MTV. RFs had a significant role in predicting the diagnosis of SPN, but their accuracies were directly related to the scanner.
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Affiliation(s)
- Domenico Albano
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (L.C.); (F.D.); (R.G.); (F.B.)
- Correspondence:
| | - Roberto Gatta
- Dipartimento di Scienze Cliniche e Sperimentali dell’Università degli Studi di Brescia, 25128 Brescia, Italy;
| | | | - Carlo Rodella
- Health Physics Department, ASST-Spedali Civili, 25123 Brescia, Italy;
| | - Luca Camoni
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (L.C.); (F.D.); (R.G.); (F.B.)
| | - Francesco Dondi
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (L.C.); (F.D.); (R.G.); (F.B.)
| | - Raffaele Giubbini
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (L.C.); (F.D.); (R.G.); (F.B.)
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia, 25123 Brescia, Italy; (L.C.); (F.D.); (R.G.); (F.B.)
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Nardone V, Boldrini L, Grassi R, Franceschini D, Morelli I, Becherini C, Loi M, Greto D, Desideri I. Radiomics in the Setting of Neoadjuvant Radiotherapy: A New Approach for Tailored Treatment. Cancers (Basel) 2021; 13:cancers13143590. [PMID: 34298803 PMCID: PMC8303203 DOI: 10.3390/cancers13143590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary This review based on a literature search aims at showing the impact of Texture Analysis in the prediction of response to neoadjuvant radiotherapy and/or chemoradiotherapy. The manuscript explores radiomics approaches in different fields of neoadjuvant radiotherapy, including esophageal cancer, lung cancer, sarcoma and rectal cancer in order to shed a light in the setting of neoadjuvant radiotherapy that can be used to tailor the best subsequent therapeutical strategy. Abstract Introduction: Neoadjuvant radiotherapy is currently used mainly in locally advanced rectal cancer and sarcoma and in a subset of non-small cell lung cancer and esophageal cancer, whereas in other diseases it is under investigation. The evaluation of the efficacy of the induction strategy is made possible by performing imaging investigations before and after the neoadjuvant therapy and is usually challenging. In the last decade, texture analysis (TA) has been developed to help the radiologist to quantify and identify the parameters related to tumor heterogeneity, which cannot be appreciated by the naked eye. The aim of this narrative is to review the impact of TA on the prediction of response to neoadjuvant radiotherapy and or chemoradiotherapy. Materials and Methods: Key references were derived from a PubMed query. Hand searching and ClinicalTrials.gov were also used. Results: This paper contains a narrative report and a critical discussion of radiomics approaches in different fields of neoadjuvant radiotherapy, including esophageal cancer, lung cancer, sarcoma, and rectal cancer. Conclusions: Radiomics can shed a light on the setting of neoadjuvant therapies that can be used to tailor subsequent approaches or even to avoid surgery in the future. At the same, these results need to be validated in prospective and multicenter trials.
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Affiliation(s)
- Valerio Nardone
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (V.N.); (R.G.)
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Luca Boldrini
- Radiation Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (V.N.); (R.G.)
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
| | - Davide Franceschini
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Milan, Italy;
| | - Ilaria Morelli
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
- Correspondence: ; Tel.: +39-055-7947719
| | - Carlotta Becherini
- Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | - Mauro Loi
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (M.L.); (D.G.); (I.D.)
| | - Daniela Greto
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (M.L.); (D.G.); (I.D.)
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (M.L.); (D.G.); (I.D.)
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy
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21
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Masson I, Da-Ano R, Lucia F, Doré M, Castelli J, Goislard de Monsabert C, Ramée JF, Sellami S, Visvikis D, Hatt M, Schick U. Statistical harmonization can improve the development of a multicenter CT-based radiomic model predictive of nonresponse to induction chemotherapy in laryngeal cancers. Med Phys 2021; 48:4099-4109. [PMID: 34008178 DOI: 10.1002/mp.14948] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 04/18/2021] [Accepted: 05/06/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To develop a radiomic model predicting nonresponse to induction chemotherapy in laryngeal cancers, from multicenter pretherapeutic contrast-enhanced computed tomography (CE-CT) and evaluate the benefit of feature harmonization in such a context. METHODS Patients (n = 104) eligible for laryngeal preservation chemotherapy were included in five centers. Primary tumor was manually delineated on the CE-CT images. The following radiomic features were extracted with an in-house software (MIRAS v1.1, LaTIM UMR 1101): intensity, shape, and textural features derived from Gray-Level Co-occurrence Matrix (GLCM), Neighborhood Gray Tone Difference Matrix (NGTDM), Gray-Level Run Length Matrix (GLRLM), and Gray-Level Size Zone Matrix (GLSZM). Harmonization was performed using ComBat after unsupervised hierarchical clustering, used to determine labels automatically, given the high heterogeneity of imaging characteristics across and within centers. Patients with similar feature distributions were grouped with unsupervised clustering into an optimal number of clusters (2) determined with "silhouette scoring." Statistical harmonization was then carried out with ComBat on these 2 identified clusters. The cohort was split into training/validation (n = 66) and testing (n = 32) sets. Area under the receiver operating characteristics curves (AUC) were used to evaluate the ability of radiomic features (before and after harmonization) to predict nonresponse to chemotherapy, and specificity (Sp) and sensitivity (Se) were used to quantify their performance in the testing set. RESULTS Without harmonization, none of the features identified as predictive in the training set remained significant in the testing set. After ComBat, one textural feature identified in the training set keeps a predictive trend in the testing set-Zone Percentage, derived from the GLSZM, was predictive of nonresponse in the training set (AUC = 0.62, Se = 70%, Sp = 64%, P = 0.04) and obtained a satisfactory performance in the testing set (Se = 80%, Sp = 67%, P = 0.03), although significance was limited by the size of the testing set. These results are consistent with previously published findings in head and neck cancers. CONCLUSIONS Radiomic features from CE-CT could help in the selection of patients for induction chemotherapy in laryngeal cancers, with relatively good sensitivity and specificity in predicting lack of response. Statistical harmonization with ComBat and unsupervised clustering seems to improve the predictive value of features extracted in such a heterogeneous multicenter setting.
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Affiliation(s)
| | | | - François Lucia
- LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France.,Radiation Oncology Department, University Hospital, Brest, France
| | - Mélanie Doré
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest René-Gauducheau, Saint-Herblain, France
| | - Joel Castelli
- Radiotherapy Department Cancer, Institute Eugène Marquis, Rennes, France.,University of Rennes 1, LTSI, Rennes, France
| | | | - Jean-François Ramée
- Department of Medical Oncology, Centre Hospitalier de Vendée, La Roche sur Yon, France
| | - Selima Sellami
- Radiation Oncology Department, University Hospital, Brest, France.,Radiotherapy Department, Centre Hospitalier de Cornouaille, Quimper, France
| | | | - Mathieu Hatt
- LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France
| | - Ulrike Schick
- LaTIM, INSERM, UMR 1101, Univ Brest, Brest, France.,Radiation Oncology Department, University Hospital, Brest, France
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El Ayachy R, Giraud N, Giraud P, Durdux C, Giraud P, Burgun A, Bibault JE. The Role of Radiomics in Lung Cancer: From Screening to Treatment and Follow-Up. Front Oncol 2021; 11:603595. [PMID: 34026602 PMCID: PMC8131863 DOI: 10.3389/fonc.2021.603595] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/06/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Lung cancer represents the first cause of cancer-related death in the world. Radiomics studies arise rapidly in this late decade. The aim of this review is to identify important recent publications to be synthesized into a comprehensive review of the current status of radiomics in lung cancer at each step of the patients' care. METHODS A literature review was conducted using PubMed/Medline for search of relevant peer-reviewed publications from January 2012 to June 2020. RESULTS We identified several studies at each point of patient's care: detection and classification of lung nodules (n=16), determination of histology and genomic (n=10) and finally treatment outcomes predictions (=23). We reported the methodology of those studies and their results and discuss the limitations and the progress to be made for clinical routine applications. CONCLUSION Promising perspectives arise from machine learning applications and radiomics based models in lung cancers, yet further data are necessary for their implementation in daily care. Multicentric collaboration and attention to quality and reproductivity of radiomics studies should be further consider.
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Affiliation(s)
- Radouane El Ayachy
- Radiation Oncology Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- Cancer Research and Personalized Medicine-Integrated Cancer Research Center (SIRIC), Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- INSERM UMR 1138 Team 22: Information Sciences to support Personalized Medicine, Cordeliers Research Centre, Paris Descartes University, Paris, France
| | - Nicolas Giraud
- INSERM UMR 1138 Team 22: Information Sciences to support Personalized Medicine, Cordeliers Research Centre, Paris Descartes University, Paris, France
- Radiation Oncology Department, Haut-Lévêque Hospital, CHU de Bordeaux, Pessac, France
| | - Paul Giraud
- Radiation Oncology Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- Cancer Research and Personalized Medicine-Integrated Cancer Research Center (SIRIC), Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- INSERM UMR 1138 Team 22: Information Sciences to support Personalized Medicine, Cordeliers Research Centre, Paris Descartes University, Paris, France
| | - Catherine Durdux
- Radiation Oncology Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- Cancer Research and Personalized Medicine-Integrated Cancer Research Center (SIRIC), Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Philippe Giraud
- Radiation Oncology Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- Cancer Research and Personalized Medicine-Integrated Cancer Research Center (SIRIC), Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Anita Burgun
- Cancer Research and Personalized Medicine-Integrated Cancer Research Center (SIRIC), Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- INSERM UMR 1138 Team 22: Information Sciences to support Personalized Medicine, Cordeliers Research Centre, Paris Descartes University, Paris, France
| | - Jean Emmanuel Bibault
- Radiation Oncology Department, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- Cancer Research and Personalized Medicine-Integrated Cancer Research Center (SIRIC), Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
- INSERM UMR 1138 Team 22: Information Sciences to support Personalized Medicine, Cordeliers Research Centre, Paris Descartes University, Paris, France
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23
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Zhao B. Understanding Sources of Variation to Improve the Reproducibility of Radiomics. Front Oncol 2021; 11:633176. [PMID: 33854969 PMCID: PMC8039446 DOI: 10.3389/fonc.2021.633176] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/01/2021] [Indexed: 12/12/2022] Open
Abstract
Radiomics is the method of choice for investigating the association between cancer imaging phenotype, cancer genotype and clinical outcome prediction in the era of precision medicine. The fast dispersal of this new methodology has benefited from the existing advances of the core technologies involved in radiomics workflow: image acquisition, tumor segmentation, feature extraction and machine learning. However, despite the rapidly increasing body of publications, there is no real clinical use of a developed radiomics signature so far. Reasons are multifaceted. One of the major challenges is the lack of reproducibility and generalizability of the reported radiomics signatures (features and models). Sources of variation exist in each step of the workflow; some are controllable or can be controlled to certain degrees, while others are uncontrollable or even unknown. Insufficient transparency in reporting radiomics studies further prevents translation of the developed radiomics signatures from the bench to the bedside. This review article first addresses sources of variation, which is illustrated using demonstrative examples. Then, it reviews a number of published studies and progresses made to date in the investigation and improvement of feature reproducibility and model performance. Lastly, it discusses potential strategies and practical considerations to reduce feature variability and improve the quality of radiomics study. This review focuses on CT image acquisition, tumor segmentation, quantitative feature extraction, and the disease of lung cancer.
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Affiliation(s)
- Binsheng Zhao
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States
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24
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Varghese BA, Hwang D, Cen SY, Lei X, Levy J, Desai B, Goodenough DJ, Duddalwar VA. Identification of robust and reproducible CT-texture metrics using a customized 3D-printed texture phantom. J Appl Clin Med Phys 2021; 22:98-107. [PMID: 33434374 PMCID: PMC7882093 DOI: 10.1002/acm2.13162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the robustness and reproducibility of computed tomography-based texture analysis (CTTA) metrics extracted from CT images of a customized texture phantom built for assessing the association of texture metrics to three-dimensional (3D) printed progressively increasing textural heterogeneity. MATERIALS AND METHODS A custom-built 3D-printed texture phantom comprising of six texture patterns was used to evaluate the robustness and reproducibility of a radiomics panel under a variety of routine abdominal imaging protocols. The phantom was scanned on four CT scanners (Philips, Canon, GE, and Siemens) to assess reproducibility. The robustness assessment was conducted by imaging the texture phantom across different CT imaging parameters such as slice thickness, field of view (FOV), tube voltage, and tube current for each scanner. The texture panel comprised of 387 features belonging to 15 subgroups of texture extraction methods (e.g., Gray-level Co-occurrence Matrix: GLCM). Twelve unique image settings were tested on all the four scanners (e.g., FOV125). Interclass correlation two-way mixed with absolute agreement (ICC3) was used to assess the robustness and reproducibility of radiomic features. Linear regression was used to test the association between change in radiomic features and increased texture heterogeneity. Results were summarized in heat maps. RESULTS A total of 5612 (23.2%) of 24 090 features showed excellent robustness and reproducibility (ICC ≥ 0.9). Intensity, GLCM 3D, and gray-level run length matrix (GLRLM) 3D features showed best performance. Among imaging variables, changes in slice thickness affected all metrics more intensely compared to other imaging variables in reducing the ICC3. From the analysis of linear trend effect of the CTTA metrics, the top three metrics with high linear correlations across all scanners and scanning settings were from the GLRLM 2D/3D and discrete cosine transform (DCT) texture family. CONCLUSION The choice of scanner and imaging protocols affect texture metrics. Furthermore, not all CTTA metrics have a linear association with linearly varying texture patterns.
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Affiliation(s)
- Bino A. Varghese
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Darryl Hwang
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Steven Y. Cen
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | - Xiaomeng Lei
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | | | - Bhushan Desai
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
| | | | - Vinay A. Duddalwar
- Department of RadiologyUniversity of Southern CaliforniaLos AngelesCAUSA
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25
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Pavic M, Bogowicz M, Kraft J, Vuong D, Mayinger M, Kroeze SGC, Friess M, Frauenfelder T, Andratschke N, Huellner M, Weder W, Guckenberger M, Tanadini-Lang S, Opitz I. FDG PET versus CT radiomics to predict outcome in malignant pleural mesothelioma patients. EJNMMI Res 2020; 10:81. [PMID: 32661672 PMCID: PMC7359199 DOI: 10.1186/s13550-020-00669-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/02/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Careful selection of malignant pleural mesothelioma (MPM) patients for curative treatment is of highest importance, as the multimodal treatment regimen is challenging for patients and harbors a high risk of substantial toxicity. Radiomics-a quantitative method for image analysis-has shown its prognostic ability in different tumor entities and could therefore play an important role in optimizing patient selection for radical cancer treatment. So far, radiomics as a prognostic tool in MPM was not investigated. MATERIALS AND METHODS This study is based on 72 MPM patients treated with surgery in a curative intent at our institution between 2009 and 2017. Pre-treatment Fluorine-18 fluorodeoxyglucose (FDG) PET and CT scans were used for radiomics outcome modeling. After extraction of 1404 CT and 1410 FDG PET features from each image, a preselection by principal component analysis was performed to include only robust, non-redundant features for the cox regression to predict the progression-free survival (PFS) and the overall survival (OS). Results were validated on a separate cohort. Additionally, SUVmax and SUVmean, and volume were tested for their prognostic ability for PFS and OS. RESULTS For the PFS a concordance index (c-index) of 0.67 (95% CI 0.52-0.82) and 0.66 (95% CI 0.57-0.78) for the training cohort (n = 36) and internal validation cohort (n = 36), respectively, were obtained for the PET radiomics model. The PFS advantage of the low-risk group translated also into an OS advantage. On CT images, no radiomics model could be trained. SUV max and SUV mean were also not prognostic in terms of PFS and OS. CONCLUSION We were able to build a successful FDG PET radiomics model for the prediction of PFS in MPM. Radiomics could serve as a tool to aid clinical decision support systems for treatment of MPM in future.
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Affiliation(s)
- M Pavic
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | - M Bogowicz
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - J Kraft
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - D Vuong
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - M Mayinger
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - S G C Kroeze
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - M Friess
- Department of Thoracic Surgery, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - T Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - N Andratschke
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - M Huellner
- Department of Nuclear Medicine, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - W Weder
- Department of Thoracic Surgery, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - M Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - S Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - I Opitz
- Department of Thoracic Surgery, University Hospital Zurich and University Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
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