Hinzpeter Ricarda, Mirshahvalad Seyed Ali, Kulanthaivelu Roshini, Ortega Claudia, Metser Ur, Liu Zhihui A, Elimova Elena, Wong Rebecca K S, Yeung Jonathan, Jang Raymond Woo-Jun, Veit-Haibach Patrick
Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada.
Cancers (Basel). 2022 Oct 28;14(21):5314. doi: 10.3390/cancers14215314.
We investigated, whether 18[18F]-FDG PET/CT-derived radiomics combined with sarcopenia measurements improves survival prognostication among patients with advanced, metastatic gastroesophageal cancer. In our study, 128 consecutive patients with advanced, metastatic esophageal and gastroesophageal cancer (n = 128; 26 females; 102 males; mean age 63.5 ± 11.7 years; age range: 29−91 years) undergoing 18[18F]-FDG PET/CT for staging between November 2008 and December 2019 were included. Segmentation of the primary tumor and radiomics analysis derived from PET and CT images was performed semi-automatically with a commonly used open-source software platform (LIFEX, Version 6.30, lifexsoft.org). Patients’ nutritional status was determined by measuring the skeletal muscle index (SMI) at the level of L3 on the CT component. Univariable and multivariable analyses were performed to establish a survival prediction model including radiomics, clinical data, and SMI score. Univariable Cox proportional hazards model revealed ECOG (<0.001) and bone metastasis (p = 0.028) to be significant clinical parameters for overall survival (OS) and progression free survival (PFS). Age (p = 0.017) was an additional prognostic factor for OS. Multivariable analysis showed improved prognostication for overall and progression free survival when adding sarcopenic status, PET and CT radiomics to the model with clinical parameters only. PET and CT radiomics derived from hybrid 18[18F]-FDG PET/CT combined with sarcopenia measurements and clinical parameters may improve survival prediction among patients with advanced, metastatic gastroesophageal cancer.
我们研究了18[18F]-FDG PET/CT衍生的放射组学结合肌肉减少症测量是否能改善晚期转移性胃食管癌患者的生存预后。在我们的研究中，纳入了2008年11月至2019年12月期间连续128例接受18[18F]-FDG PET/CT分期的晚期转移性食管癌和胃食管癌患者（n = 128；女性26例；男性102例；平均年龄63.5±11.7岁；年龄范围：29 - 91岁）。使用常用的开源软件平台（LIFEX，版本6.30，lifexsoft.org）对原发肿瘤进行半自动分割，并对PET和CT图像进行放射组学分析。通过测量CT图像上L3水平的骨骼肌指数（SMI）来确定患者的营养状况。进行单变量和多变量分析以建立包括放射组学、临床数据和SMI评分的生存预测模型。单变量Cox比例风险模型显示，ECOG（<0.001）和骨转移（p = 0.028）是总生存期（OS）和无进展生存期（PFS）的重要临床参数。年龄（p = 0.017）是OS的另一个预后因素。多变量分析表明，在仅包含临床参数的模型中加入肌肉减少症状态、PET和CT放射组学后，总生存期和无进展生存期的预后得到改善。源自混合18[18F]-FDG PET/CT的PET和CT放射组学结合肌肉减少症测量和临床参数可能改善晚期转移性胃食管癌患者的生存预测。
