Predicting response to neoadjuvant chemoradiotherapy in esophageal cancer with textural features derived from pre-treatment 18F-FDG PET/CT imaging
| Autor: | John T. M. Plukker, Johannes G. M. Burgerhof, Cornelis H. Slump, Veronique E.M. Mul, Roelof J. Beukinga, Gursah Kats-Ugurlu, Christina T. Muijs, Lisanne V. van Dijk, J. Hulshoff, Riemer H. J. A. Slart |
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| Přispěvatelé: | Biomedical Photonic Imaging, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Life Course Epidemiology (LCE), Vascular Ageing Programme (VAP), Cardiovascular Centre (CVC), Translational Immunology Groningen (TRIGR), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment TUMOR HETEROGENEITY HYPOXIA Logistic regression CLASSIFICATION 030218 nuclear medicine & medical imaging METIS-320193 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine textural analysis POSITRON-EMISSION-TOMOGRAPHY medicine Radiology Nuclear Medicine and imaging esophageal cancer FDG-PET Tumor Regression Grade medicine.diagnostic_test business.industry PATHOLOGICAL RESPONSE Esophageal cancer medicine.disease F-18-FDG PET/CT Carboplatin CHEMORADIATION THERAPY chemistry Positron emission tomography Esophagectomy 030220 oncology & carcinogenesis SURVIVAL T-stage response prediction Radiology SQUAMOUS-CELL CARCINOMA Nuclear medicine business PREOPERATIVE CHEMORADIOTHERAPY Predictive modelling |
| Zdroj: | The Journal of nuclear medicine, 58(5), 723-729. Society of Nuclear Medicine Inc. Journal of Nuclear Medicine, 58(5), 723-729. SOC NUCLEAR MEDICINE INC |
| ISSN: | 0161-5505 |
| Popis: | Adequate prediction of tumor response to neoadjuvant chemoradiotherapy (nCRT) in esophageal cancer (EC) patients is important in a more personalized treatment. The current best clinical method to predict pathologic complete response is SUVmax in F-18-FDG PET/ CT imaging. To improve the prediction of response, we constructed a model to predict complete response to nCRT in EC based on pretreatment clinical parameters and F-18-FDG PET/CT-derived textural features. Methods: From a prospectively maintained single institution database, we reviewed 97 consecutive patients with locally advanced EC and a pretreatment F-18-FDG PET/CT scan between 2009 and 2015. All patients were treated with nCRT (carboplatin/paclitaxe1/41.4 Gy) followed by esophagectomy. We analyzed clinical, geometric, and pretreatment textural features extracted from both F-18-FDG PET and CT. The current most accurate prediction model with SUVmax as a predictor variable was compared with 6 different response prediction models constructed using least absolute shrinkage and selection operator regularized logistic regression. Internal validation was performed to estimate the model's performances. Pathologic response was defined as complete versus incomplete response (Mandard tumor regression grade system 1 vs. 2-5). Results: Pathologic examination revealed 19 (19.6%) complete and 78 (80.4%) incomplete responders. Least absolute shrinkage and selection operator regularization selected the clinical parameters: histologic type and clinical T stage, the 18F-FDG PET-derived textural feature long run low gray level emphasis, and the CT-derived textural feature run percentage. Introducing these variables to a logistic regression analysis showed areas under the receiver-operating-characteristic curve (AUCs) of 0.78 compared with 0.58 in the SUVmax model. The discrimination slopes were 0.17 compared with 0.01, respectively. After internal validation, the AUCs decreased to 0.74 and 0.54, respectively. Conclusion: The predictive values of the constructed models were superior to the standard method (SUVmax). These results can be considered as an initial step in predicting tumor re sponse to nCRT in locally advanced EC. Further research in refining the predictive value of these models is needed to justify omission of surgery. |
| Databáze: | OpenAIRE |
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