Eifer Michal, Peters-Founshtein Gregory, Yoel Lotem Cohn, Pinian Hodaya, Steiner Roee, Klang Eyal, Catalano Onofrio A, Eshet Yael, Domachevsky Liran
Department of Nuclear Imaging, Sheba Medical Center, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Rep Pract Oncol Radiother. 2024 Jun 6;29(2):211-218. doi: 10.5603/rpor.99906. eCollection 2024.
Attainment of a complete histopathological response following neoadjuvant therapy has been associated with favorable long-term survival outcomes in esophageal cancer patients. We investigated the ability of F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) radiomic features to predict the pathological response to neoadjuvant treatment in patients with esophageal cancer.
A retrospective review of medical records of patients with locally advanced resectable esophageal or esophagogastric junctional cancers. Included patients had a baseline FDG PET/CT scan and underwent Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) protocol followed by surgery. Four demographic variables and 107 PET radiomic features were extracted and analyzed using univariate and multivariate analyses to predict response to neoadjuvant therapy.
Overall, 53 FDG-avid primary esophageal cancer lesions were segmented and radiomic features were extracted. Seventeen radiomic features and 2 non-radiomics variables were found to exhibit significant differences between neoadjuvant therapy responders and non-responders. An unsupervised hierarchical clustering analysis using these 19 variables classified patients in a manner significantly associated with response to neoadjuvant treatment (p < 0.01).
Our findings highlight the potential of FDG PET/CT radiomic features as a predictor for the response to neoadjuvant therapy in esophageal cancer patients. The combination of these radiomic features with select non-radiomic variables provides a model for stratifying patients based on their likelihood to respond to neoadjuvant treatment.
新辅助治疗后达到完全组织病理学缓解与食管癌患者良好的长期生存结果相关。我们研究了氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）影像组学特征预测食管癌患者新辅助治疗病理反应的能力。
对局部晚期可切除食管癌或食管胃交界癌患者的病历进行回顾性研究。纳入的患者进行了基线FDG PET/CT扫描，并按照食管癌新辅助放化疗后手术研究（CROSS）方案接受放化疗，随后接受手术。提取了四个人口统计学变量和107个PET影像组学特征，并使用单因素和多因素分析来预测对新辅助治疗的反应。
总体而言，对53个FDG摄取阳性的原发性食管癌病灶进行了分割并提取了影像组学特征。发现17个影像组学特征和2个非影像组学变量在新辅助治疗反应者和无反应者之间存在显著差异。使用这19个变量进行的无监督层次聚类分析对患者的分类方式与对新辅助治疗的反应显著相关（p < 0.01）。
我们的研究结果突出了FDG PET/CT影像组学特征作为食管癌患者新辅助治疗反应预测指标的潜力。这些影像组学特征与选定的非影像组学变量相结合，为根据患者对新辅助治疗的反应可能性对患者进行分层提供了一个模型。
