Dankulchai Pittaya, Thanamitsomboon Natthakorn, Sittiwong Wiwatchai, Kosaisawe Nont, Thephamongkhol Kullathorn, Phongprapun Wisawa, Prasartseree Tissana
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Molecular and Cellular Biology, University of California Davis, Davis, USA.
J Contemp Brachytherapy. 2024 Jun;16(3):193-201. doi: 10.5114/jcb.2024.141458. Epub 2024 Jun 28.
The aim of this study was to investigate the predictive value of radiomic features of pre-treatment T2-weighted magnetic resonance images (MRI) for clinical outcomes of radiotherapy in cervical cancer patients.
Ninety cervical cancer patients with stage IB-IVA were retrospectively analyzed. All patients received definitive radiotherapy with or without concurrent chemotherapy. Radiomic features were extracted from gross tumor volume (GTV) on pre-treatment T2-weighted MRI. The association between radiomic features and loco-regional recurrence (LRR) was analyzed with Student's test, and false discovery rate was controlled using Storey method. Multivariate analysis with significant radiomic features with -value < 0.01 and known clinical prognostic factors was performed using Cox proportional hazard model.
The majority of patients were stage IIIB (47.8%) and stage IIB (36.7%), and the most common histology was squamous cell carcinoma (74.5%). The median GTV volume was 37.5 ml (IQR, 16.3-93.1). The median dose of D received by high-risk clinical target volume (HR-CTV) was 86.2 Gy (IQR, 67.2-94.2). In a median follow-up time of 29.2 months, 12 of the 90 patients (13.3%) developed LRR. Eighty radiomic features were collected. There were four radiomic features, which showed significant correlation with LRR: Maximum intensity ( = 0.0002), Correlation135 GLCM ( = 0.0014), Correlation90 ( = 0.0015), and Correlation45 ( = 0.0034). Cox regression analysis yielded a significant hazard ratio for the maximum intensity ( = 0.038) and Correlation135 GLCM ( = 0.013) features. There was no statistically significant association for overall survival with any radiomic features.
The maximum intensity and Correlation135 GLCM radiomic features of the pre-treatment T2-weighted MR images are predictive of loco-regional recurrence in cervical cancer patients after definitive radiotherapy with 3D-IGABT.
本研究旨在探讨治疗前T2加权磁共振成像（MRI）的放射组学特征对宫颈癌患者放疗临床结局的预测价值。
回顾性分析90例IB-IVA期宫颈癌患者。所有患者均接受了确定性放疗，部分患者同时接受了化疗。从治疗前T2加权MRI上的大体肿瘤体积（GTV）中提取放射组学特征。采用Student检验分析放射组学特征与局部区域复发（LRR）之间的相关性，并使用Storey方法控制错误发现率。使用Cox比例风险模型对具有显著放射组学特征（P值<0.01）和已知临床预后因素进行多变量分析。
大多数患者为IIIB期（47.8%）和IIB期（36.7%），最常见的组织学类型为鳞状细胞癌（74.5%）。GTV体积中位数为37.5 ml（四分位间距，16.3-93.1）。高危临床靶区（HR-CTV）接受的D剂量中位数为86.2 Gy（四分位间距，67.2-94.2）。在中位随访时间29.2个月时，90例患者中有12例（13.3%）发生LRR。收集了80个放射组学特征。有4个放射组学特征与LRR显著相关：最大强度（P = 0.0002）、Correlation135 GLCM（P = 0.0014）、Correlation90（P = 0.0015）和Correlation45（P = 0.0034）。Cox回归分析得出最大强度（P = 0.038）和Correlation135 GLCM（P = 0.013）特征的显著风险比。任何放射组学特征与总生存均无统计学显著关联。
治疗前T2加权MR图像的最大强度和Correlation135 GLCM放射组学特征可预测宫颈癌患者在接受3D-IGABT确定性放疗后的局部区域复发。
