Wallace H. Coulter Department of Biomedical Engineering, Emory University, Atlanta, GA, USA.
The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
Transl Vis Sci Technol. 2024 Jan 2;13(1):29. doi: 10.1167/tvst.13.1.29.
PURPOSE: The goal of this study was to evaluate the role of texture-based baseline radiomic features (Fr) and dynamic radiomics alterations (delta, FΔr) within multiple targeted compartments on optical coherence tomography (OCT) scans to predict response to anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (nAMD). METHODS: HAWK is a phase 3 clinical trial data set of active nAMD patients (N = 1082) comparing brolucizumab and aflibercept. This analysis included patients receiving 6 mg brolucizumab or 2 mg aflibercept and categorized as complete responders (n = 280) and incomplete responders (n = 239) based on whether or not the eyes achieved/maintained fluid resolution on OCT. A total of 481 Fr were extracted from each of the fluid, subretinal hyperreflective material (SHRM), retinal tissue, and sub-retinal pigment epithelium (RPE) compartments. Most discriminating eight baseline features, selected by the minimum redundancy, maximum relevance feature selection, were evaluated using a quadratic discriminant analysis (QDA) classifier on the training set (Str, n = 363) to differentiate between the two patient groups. Classifier performance was subsequently validated on independent test set (St, n = 156). RESULTS: In total, 519 participants were included in this analysis from the HAWK phase 3 study. There were 280 complete responders and 219 incomplete responders. Compartmental analysis of radiomics featured identified the sub-RPE and SHRM compartments as the most distinguishing between the two response groups. The QDA classifier yielded areas under the curve of 0.78, 0.79, and 0.84, respectively, using Fr, FΔr, and combined Fr, FΔr, and Fc on St. CONCLUSIONS: Utilizing compartmental static and dynamic radiomics features, unique differences were identified between eyes that respond differently to anti-VEGF therapy in a large phase 3 trial that may provide important predictive value. TRANSLATIONAL RELEVANCE: Imaging biomarkers, such as radiomics features identified in this analysis, for predicting treatment response are needed to enhanced precision medicine in the management of nAMD.
目的:本研究旨在评估基于纹理的基线放射组学特征(Fr)和光学相干断层扫描(OCT)扫描中多个靶向容积的动态放射组学改变(delta,FΔr)在预测抗血管内皮生长因子(VEGF)治疗新生血管性年龄相关性黄斑变性(nAMD)中的作用。
方法:HAWK 是一项比较 brolucizumab 和 aflibercept 的 3 期临床试验数据集,纳入了活动性 nAMD 患者(N=1082)。本分析纳入了接受 6mg brolucizumab 或 2mg aflibercept 的患者,根据 OCT 上是否达到/维持液体分辨率将其分为完全应答者(n=280)和不完全应答者(n=239)。从液体、视网膜下高反射物质(SHRM)、视网膜组织和视网膜下色素上皮(RPE)容积中分别提取了 481 个 Fr。采用最小冗余最大相关性特征选择方法选择的 8 个最具鉴别力的基线特征,在训练集(Str,n=363)上采用二次判别分析(QDA)分类器进行评估,以区分两组患者。随后在独立测试集(St,n=156)上验证分类器性能。
结果:本研究共纳入了来自 HAWK 3 期研究的 519 名参与者。其中有 280 名完全应答者和 219 名不完全应答者。放射组学特征的容积分析确定了 RPE 下和 SHRM 容积是区分两组反应的最具特征性的。QDA 分类器在 St 上使用 Fr、FΔr 和 Fr、FΔr 和 Fc 的组合,分别获得了 0.78、0.79 和 0.84 的曲线下面积。
结论:利用容积静态和动态放射组学特征,在大型 3 期临床试验中发现了对抗 VEGF 治疗反应不同的眼睛之间的独特差异,这可能提供重要的预测价值。
翻译后的文本符合中文的表达方式和用词习惯,能够准确地表达原文的意思。
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