Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea.
Sci Rep. 2017 May 8;7(1):1556. doi: 10.1038/s41598-017-01524-7.
Radiomics has been spotlighted as imaging biomarker for estimation of intratumoral heterogeneity (ITH) which is regarded as the main reason for resistance to tumor treatment. Although a number of studies has shown clinical evidences that separate measurement of metabolic ITH by texture features (TFs) on F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) has prognostic ability in various tumors, there has been no consensus regarding the best parameter representing ITH. Besides, it is yet uncertain that TFs are useful for estimation of histopathologic markers, prediction of response to neoadjuvant chemotherapy (NAC), or prognostic ability in breast cancer. To depart from the traditional approach, we evaluated the clinical usefulness of integrated metabolic radiomics using unsupervised clustering with 109 TFs measured from pretreatment F-FDG PET/CT scans of 73 patients with locally advanced breast cancer (LABC) underwent NAC before surgery. Our study shows that metabolic radiomics patterns of LABC are associated with Ki67 expression, achievement of pathologic complete response after NAC, and risk of recurrence. Integrated metabolic radiomics has potential for clinically relevant pretreatment biomarker with predictive and prognostic ability for personalized management in LABC.
放射组学已成为评估肿瘤内异质性（ITH）的影像学生物标志物而受到关注，ITH 被认为是肿瘤治疗耐药的主要原因。尽管许多研究已经表明，通过 F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）上的纹理特征（TFs）单独测量代谢 ITH 具有各种肿瘤的预后能力，但仍未就代表 ITH 的最佳参数达成共识。此外，TFs 是否有助于评估组织病理学标志物、预测新辅助化疗（NAC）的反应或在乳腺癌中的预后能力尚不确定。为了摆脱传统方法，我们使用无监督聚类评估了来自 73 名局部晚期乳腺癌（LABC）患者术前 F-FDG PET/CT 扫描中测量的 109 个 TF 的综合代谢放射组学的临床实用性，这些患者在手术前接受了 NAC。我们的研究表明，LABC 的代谢放射组学模式与 Ki67 表达、NAC 后病理完全缓解的实现以及复发风险相关。综合代谢放射组学具有作为临床相关预处理生物标志物的潜力，具有预测和预后能力，可用于 LABC 的个体化管理。
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