Department of Radiology, Columbia University Medical Center, New York, New York.
Bristol Myers Squibb, Princeton, New Jersey.
J Thorac Oncol. 2023 May;18(5):587-598. doi: 10.1016/j.jtho.2022.12.019. Epub 2023 Jan 13.
We aimed to define a baseline radiomic signature associated with overall survival (OS) using baseline computed tomography (CT) images obtained from patients with NSCLC treated with nivolumab or chemotherapy.
The radiomic signature was developed in patients with NSCLC treated with nivolumab in CheckMate-017, -026, and -063. Nivolumab-treated patients were pooled and randomized to training, calibration, or validation sets using a 2:1:1 ratio. From baseline CT images, volume of tumor lesions was semiautomatically segmented, and 38 radiomic variables depicting tumor phenotype were extracted. Association between the radiomic signature and OS was assessed in the nivolumab-treated (validation set) and chemotherapy-treated (test set) patients in these studies.
A baseline radiomic signature was identified using CT images obtained from 758 patients. The radiomic signature used a combination of imaging variables (spatial correlation, tumor volume in the liver, and tumor volume in the mediastinal lymph nodes) to output a continuous value, ranging from 0 to 1 (from most to least favorable estimated OS). Given a threshold of 0.55, the sensitivity and specificity of the radiomic signature for predicting 3-month OS were 86% and 77.8%, respectively. The signature was identified in the training set of patients treated with nivolumab and was significantly associated (p < 0.0001) with OS in patients treated with nivolumab or chemotherapy.
The radiomic signature provides an early readout of the anticipated OS in patients with NSCLC treated with nivolumab or chemotherapy. This could provide important prognostic information and may support risk stratification in clinical trials.
我们旨在利用非小细胞肺癌（NSCLC）患者接受纳武单抗或化疗治疗时的基线计算机断层扫描（CT）图像，定义与总生存期（OS）相关的基线放射组学特征。
在 CheckMate-017、-026 和 -063 中接受纳武单抗治疗的 NSCLC 患者中开发了放射组学特征。纳武单抗治疗的患者按照 2:1:1 的比例进行分组，分为训练组、校准组和验证组。从基线 CT 图像中，半自动分割肿瘤病变体积，并提取 38 个描述肿瘤表型的放射组学变量。在这些研究中，使用纳武单抗治疗（验证组）和化疗治疗（测试组）的患者评估放射组学特征与 OS 的相关性。
使用来自 758 例患者的 CT 图像确定了一个基线放射组学特征。该放射组学特征使用成像变量（空间相关性、肝脏肿瘤体积和纵隔淋巴结肿瘤体积）的组合来输出一个连续值，范围从 0 到 1（从最有利于估计 OS 到最不利于估计 OS）。给定 0.55 的阈值，放射组学特征预测 3 个月 OS 的敏感性和特异性分别为 86%和 77.8%。该特征在接受纳武单抗治疗的患者的训练组中得到确定，并与接受纳武单抗或化疗治疗的患者的 OS 显著相关（p < 0.0001）。
放射组学特征为接受纳武单抗或化疗治疗的 NSCLC 患者提供了预期 OS 的早期读数。这可能提供重要的预后信息，并可能支持临床试验中的风险分层。
