Kulanthaivelu Roshini, Kohan Andres, Hinzpeter Ricarda, Liu Zhihui Amy, Hope Andrew, Huang Shao Hui, Waldron John, O'Sullivan Brian, Ortega Claudia, Metser Ur, Veit-Haibach Patrick
Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Front Oncol. 2022 Oct 24;12:952763. doi: 10.3389/fonc.2022.952763. eCollection 2022.
Radiomics is an emerging imaging assessment technique that has shown promise in predicting survival among nasopharyngeal carcinoma (NPC) patients. Studies so far have focused on PET or MR-based radiomics independently. The aim of our study was to evaluate the prognostic value of clinical and radiomic parameters derived from both PET/CT and MR.
Retrospective evaluation of 124 NPC patients with PET/CT and radiotherapy planning MR (RP-MR). Primary tumors were segmented using dedicated software (LIFEx version 6.1) from PET, CT, contrast-enhanced T1-weighted (T1-w), and T2-weighted (T2-w) MR sequences with 376 radiomic features extracted. Summary statistics describe patient, disease, and treatment characteristics. The Kaplan-Meier (KM) method estimates overall survival (OS) and progression-free survival (PFS). Clinical factors selected based on univariable analysis and the multivariable Cox model were subsequently constructed with radiomic features added.
The final models comparing clinical, clinical + RP-MR, clinical + PET/CT and clinical + RP-MR + PET/CT for OS and PFS demonstrated that combined radiomic signatures were significantly associated with improved survival prognostication (AUC 0.62 0.81 0.75 0.86 at 21 months for PFS and 0.56 0.85 0.79 0.96 at 24 months for OS). Clinical + RP-MR features initially outperform clinical + PET/CT for both OS and PFS (<18 months), and later in the clinical course for PFS (>42 months).
Our study demonstrated that PET/CT-based radiomic features may improve survival prognostication among NPC patients when combined with baseline clinical and MR-based radiomic features.
放射组学是一种新兴的成像评估技术，已显示出在预测鼻咽癌（NPC）患者生存率方面的前景。迄今为止的研究分别聚焦于基于PET或MR的放射组学。我们研究的目的是评估源自PET/CT和MR的临床及放射组学参数的预后价值。
对124例接受PET/CT检查及放射治疗计划MR（RP-MR）的NPC患者进行回顾性评估。使用专用软件（LIFEx 6.1版）从PET、CT、对比增强T1加权（T1-w）和T2加权（T2-w）MR序列中分割出原发肿瘤，提取376个放射组学特征。汇总统计描述患者、疾病和治疗特征。采用Kaplan-Meier（KM）法估计总生存期（OS）和无进展生存期（PFS）。基于单变量分析选择临床因素，随后构建多变量Cox模型并加入放射组学特征。
比较临床、临床+RP-MR、临床+PET/CT以及临床+RP-MR+PET/CT用于OS和PFS的最终模型表明，联合放射组学特征与改善生存预后显著相关（PFS在21个月时的AUC分别为0.62、0.81、0.75、0.86，OS在24个月时的AUC分别为0.56、0.85、0.79、0.96）。临床+RP-MR特征在OS和PFS方面（<18个月）最初优于临床+PET/CT，在临床病程后期对于PFS（>42个月）也是如此。
我们的研究表明，基于PET/CT的放射组学特征与基线临床及基于MR的放射组学特征相结合时，可能改善NPC患者的生存预后。
