Novel Functional Radiomics for Prediction of Cardiac Positron Emission Tomography Avidity in Lung Cancer Radiotherapy.

IF 3.3 Q2 ONCOLOGY JCO Clinical Cancer Informatics Pub Date : 2024-03-01 DOI:10.1200/CCI.23.00241
Wookjin Choi, Yingcui Jia, Jennifer Kwak, Maria Werner-Wasik, Adam P Dicker, Nicole L Simone, Eugene Storozynsky, Varsha Jain, Yevgeniy Vinogradskiy
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Abstract

Purpose: Traditional methods of evaluating cardiotoxicity focus on radiation doses to the heart. Functional imaging has the potential to provide improved prediction for cardiotoxicity for patients with lung cancer. Fluorine-18 (18F) fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) imaging is routinely obtained in a standard cancer staging workup. This work aimed to develop a radiomics model predicting clinical cardiac assessment using 18F-FDG PET/CT scans before thoracic radiation therapy.

Methods: Pretreatment 18F-FDG PET/CT scans from three study populations (N = 100, N = 39, N = 70) were used, comprising two single-institutional protocols and one publicly available data set. A clinician (V.J.) classified the PET/CT scans per clinical cardiac guidelines as no uptake, diffuse uptake, or focal uptake. The heart was delineated, and 210 novel functional radiomics features were selected to classify cardiac FDG uptake patterns. Training data were divided into training (80%)/validation (20%) sets. Feature reduction was performed using the Wilcoxon test, hierarchical clustering, and recursive feature elimination. Ten-fold cross-validation was carried out for training, and the accuracy of the models to predict clinical cardiac assessment was reported.

Results: From 202 of 209 scans, cardiac FDG uptake was scored as no uptake (39.6%), diffuse uptake (25.3%), and focal uptake (35.1%), respectively. Sixty-two independent radiomics features were reduced to nine clinically pertinent features. The best model showed 93% predictive accuracy in the training data set and 80% and 92% predictive accuracy in two external validation data sets.

Conclusion: This work used an extensive patient data set to develop a functional cardiac radiomic model from standard-of-care 18F-FDG PET/CT scans, showing good predictive accuracy. The radiomics model has the potential to provide an automated method to predict existing cardiac conditions and provide an early functional biomarker to identify patients at risk of developing cardiac complications after radiotherapy.

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用于预测肺癌放疗中心脏正电子发射断层扫描阳性率的新型功能放射组学。
目的:评估心脏毒性的传统方法侧重于心脏的辐射剂量。功能成像有可能改进肺癌患者心脏毒性的预测。氟-18 (18F) 氟脱氧葡萄糖(FDG)-正电子发射断层扫描(PET)/计算机断层扫描(CT)成像是标准癌症分期检查的常规方法。这项研究旨在开发一种放射组学模型,利用胸部放疗前的 18F-FDG PET/CT 扫描预测临床心脏评估:方法:使用来自三个研究人群(N = 100、N = 39、N = 70)的治疗前 18F-FDG PET/CT 扫描,包括两个单一机构方案和一个公开数据集。临床医生(V.J.)根据临床心脏指南将 PET/CT 扫描分为无摄取、弥漫摄取或局灶摄取。对心脏进行了划定,并选择了 210 个新的功能放射组学特征对心脏 FDG 摄取模式进行分类。训练数据分为训练集(80%)/验证集(20%)。使用 Wilcoxon 检验、分层聚类和递归特征剔除进行特征还原。对训练进行了十倍交叉验证,并报告了模型预测临床心脏评估的准确性:在 209 次扫描中,有 202 次扫描的心脏 FDG 摄取分别为无摄取(39.6%)、弥漫性摄取(25.3%)和局灶性摄取(35.1%)。62 个独立的放射组学特征被简化为 9 个临床相关特征。最佳模型在训练数据集中的预测准确率为 93%,在两个外部验证数据集中的预测准确率分别为 80% 和 92%:这项研究利用广泛的患者数据集,从标准护理18F-FDG PET/CT扫描中建立了一个功能性心脏放射组学模型,显示出良好的预测准确性。放射组学模型有望提供一种自动方法来预测现有的心脏状况,并提供一种早期功能生物标记物来识别放疗后有可能出现心脏并发症的患者。
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CiteScore
6.20
自引率
4.80%
发文量
190
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