Quantitative Imaging Biomarkers of the Whole Liver Tumor Burden Improve Survival Prediction in Metastatic Pancreatic Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Cohort
2.2. Imaging Studies
2.3. WLTB Segmentations and QIBs
2.4. Clinical Baseline Models
- Baseline log(CRP), where the natural logarithm is applied to the continuous value of CRP in mg/dl
- Baseline log(bilirubin), analogously
- ECOG 0-1 vs. two at the time of diagnosis of metastatic PC
- Baseline CA19-9 ≥1000 U/mL vs. <1000 U/mL
- Baseline CRP ≥5 mg/L vs. <5 mg/L
- Again, a CPH model is fitted and evaluated by the C-index.
2.5. Statistical Analysis
3. Results
3.1. Demographic Data
3.2. WLTB Segmentations
3.3. Survival Models
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Value | |
---|---|---|
No. of patients | 75 | |
age (y) | 64 (41–83) | |
sex | male | 50 (66.7%) |
female | 25 (33.3%) | |
primary tumor location | head | 26 (34.7%) |
body | 15 (20.0%) | |
tail | 13 (17.3%) | |
ns | 21 (28.0%) | |
tumor grading | G1 | 1 (1.3%) |
G2 | 12 (16.0%) | |
G3 | 59 (78.7%) | |
G4 | 3 (4.0%) | |
T stage | T1 | 1 (1.3%) |
T2 | 9 (12.0%) | |
T3 | 46 (61.3%) | |
T4 | 19 (25.3%) | |
N stage | N0 | 19 (25.3%) |
N1 | 55 (73.3%) | |
N2 | 1 (1.3%) | |
CA 19-9 (U/mL) | 463 (0–422,000) | |
CEA (ng/mL) | 6.3 (0.2–1697.0) | |
CRP (mg/dL) | 1.0 (0.0–18.2) | |
LDH (U/L) | 226 (128–937) | |
bilirubin (mg/dL) | 0.6 (0.3–39.8) | |
ECOG | 0 | 33 (44.0%) |
1 | 38 (50.7%) | |
2 | 3 (4.0%) | |
3 | 1 (1.3%) | |
overall survival (d) | 304 | |
whole liver tumor burden volume (cm3) | 9.3 (0.3–2832.5) | |
affected liver lobes | left | 61 (81.3%) |
right | 67 (89.3%) | |
both | 53 (70.7%) |
Parameter | HR [CI] | p |
---|---|---|
attenuation (HU) | 1.00 (0.98–1.01) | 0.632 |
volume (cm3) | 1.00 (1.00–1.00) | 0.127 * |
relative volume (%) | 0.99 (0.96–1.02) | 0.428 |
TBS | 1.02 (1.01–1.03) | 0.002 * |
bilobar disease | 2.25 (1.31–3.84) | 0.002 * |
energy | 1.00 (1.00–1.00) | 0.196 * |
compactness | 0.09 (0.02–0.44) | 0.002 * |
GLRLM nonuniformity | 1.00 (1.00–1.00) | 0.203 |
wavelet nonuniformity | 1.00 (1.00–1.00) | 0.283 |
MSx (cm) | 1.03 (1.00–1.07) | 0.083 * |
MSy (cm) | 1.04 (1.00–1.08) | 0.081 * |
MSz (cm) | 1.05 (1.01–1.10) | 0.018 * |
SA/V (1/cm) | 1.03 (0.92–1.14) | 0.618 |
Parameter | Baseline Model (Haas et al. [5]) | Extended Model 1 | ||||
---|---|---|---|---|---|---|
HR (CI) | p | C-Index | HR (CI) | p | C-Index | |
ECOG 0 vs. 1–3 | 1.59 (0.98–2.57) | 0.06 | 0.614 | 1.49 (0.91–2.42) | 0.11 | 0.736 (p = 0.0003 *) |
log(CRP) | 1.00 (0.97–1.03) | 0.99 | 0.99 (0.96–1.02) | 0.35 | ||
log(Bilirubin) | 1.18 (0.98–2.57) | 0.13 | 1.16 (0.93–1.45) | 0.20 | ||
volume [cm3] | 1.00 (1.00–1.00) | 0.06 | ||||
TBS | 1.01 (1.00–1.03) | 0.04 * | ||||
bilobar disease | 2.02 (1.09–3.75) | 0.03 * | ||||
energy | 1.00 (1.00–1.00) | 0.10 | ||||
Parameter | Baseline Model (Xue et al. [6]) | Extended Model 2 | ||||
HR (CI) | p | C-Index | HR (CI) | p | C-Index | |
ECOG 0–1 vs. 2 | 3.75 (1.27–11.14) | 0.02 * | 0.621 | 2.79 (0.94–8.30) | 0.07 | 0.699 (p = 0.003 *) |
CA19-9 ≥ 1000 [U/mL] | 1.58 (0.98–2.55) | 0.06 | 1.01 (0.57–1.77) | 0.98 | ||
CRP ≥ 5 [mg/dl] | 1.53 (0.77–3.06) | 0.23 | 1.52 (0.76–3.05) | 0.24 | ||
volume [cm3] | 1.00 (1.00–1.00) | 0.22 | ||||
TBS | 1.02 (1.00–1.03) | 0.03 * | ||||
bilobar disease | 1.86 (1.02–3.37) | 0.04 * |
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Gebauer, L.; Moltz, J.H.; Mühlberg, A.; Holch, J.W.; Huber, T.; Enke, J.; Jäger, N.; Haas, M.; Kruger, S.; Boeck, S.; et al. Quantitative Imaging Biomarkers of the Whole Liver Tumor Burden Improve Survival Prediction in Metastatic Pancreatic Cancer. Cancers 2021, 13, 5732. https://doi.org/10.3390/cancers13225732
Gebauer L, Moltz JH, Mühlberg A, Holch JW, Huber T, Enke J, Jäger N, Haas M, Kruger S, Boeck S, et al. Quantitative Imaging Biomarkers of the Whole Liver Tumor Burden Improve Survival Prediction in Metastatic Pancreatic Cancer. Cancers. 2021; 13(22):5732. https://doi.org/10.3390/cancers13225732
Chicago/Turabian StyleGebauer, Leonie, Jan H. Moltz, Alexander Mühlberg, Julian W. Holch, Thomas Huber, Johanna Enke, Nils Jäger, Michael Haas, Stephan Kruger, Stefan Boeck, and et al. 2021. "Quantitative Imaging Biomarkers of the Whole Liver Tumor Burden Improve Survival Prediction in Metastatic Pancreatic Cancer" Cancers 13, no. 22: 5732. https://doi.org/10.3390/cancers13225732