FDG-PET Radiomics for Response Monitoring in Non-Small-Cell Lung Cancer Treated with Radiation Therapy
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Cohorts
2.2. PET/CT Acquisition
2.3. Tumor Segmentation
2.4. Image Features Extraction
2.5. Statistical Analysis
2.6. Proposed Method
- Identification of the IF following a normal distribution across the pre-treatment 4D breathing phases. The objective was to ensure that the 4D protocol and the robustness of the IF were good enough to reproduce FDG-distribution quantization across the respiratory phases. For each patient, a primary lesion was segmented on each breathing phase and values for the 135 IF were computed, Figure 2. We considered that IF satisfied the selection criteria when their values across the 4D frames followed a normal distribution (Shapiro–Wilk test) in more than 70% of the patients.
- Identification of IF robustness throughout 3D and 4D PET images. The objective was to ensure that the IFs were robust enough to be reproducible with and without a motion-compensation reconstruction protocol.
- Quantification of relative IF variations during treatment ∆rIF weighted according to variability across 4D frames:
3. Results
3.1. Method Development
3.2. Prognostic Model
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Clinical Characteristics | Cohort 1 (n = 15) | Cohort 2 (n = 22) | Cohort 3 (n = 11) |
---|---|---|---|
Clinical Trial Register | NCT00697333 | NCT00697333 | DRKS00003658 |
PET-Plan | PET-Plan | STRIPE | |
Age (years, mean ± SD, range) | (67 ± 9, 51–78) | (65 ± 10, 47–83) | (74 ± 7, 60–83) |
Sex | - | - | - |
Female | 9(60%) | 6(27%) | 3(27%) |
Male | 6(40%) | 16(73%) | 8(73%) |
Tumor Localization | - | - | - |
Peripheral | 3(20%) | 7(32%) | 7(73%) |
Central | 12(80%) | 15(68%) | 3(27%) |
Stage | - | - | - |
Ib | (0%) | (0%) | 6(55%) |
IIb | (0%) | 2(9%) | 1(9%) |
IIIa | 8(53%) | 5(23%) | (0%) |
IIIb | 5(33%) | 9(41%) | (0%) |
IIIc | 1(7%) | 5(23%) | (0%) |
IV | (0%) | 1(5%) | 2(18%) |
Metastases | (0%) | (0%) | 2(18%) |
Chemotherapy | - | - | - |
Concurrent | 15(100%) | 22(100%) | (0%) |
No | (0%) | (0%) | 11(100%) |
Radiotherapy | (65 ± 11, 30–74) | (66 ± 5, 60–74) | (36 ± 1, 35–38) * |
(Gy, mean ± SD, range) | - | - | - |
Overall Survival | (47 ± 36, 1–105) | (47 ± 21,4–77) | (60 ± 31, 11–105) |
(months, mean ± SD, range) | - | - | - |
Local Recurrence (yes) | 6(40%) | 9(41%) | 2(18%) |
Distant Metastasis (yes) | 6(40%) | 15(68%) | 6(55%) |
Scannig Parameters | Cohort 1 (n = 15) | Cohort 2 (n = 22) | Cohort 3 (n = 11) |
---|---|---|---|
4D PET/CT before RT | yes | yes | yes |
PET/CT System | - | - | - |
TF-64 | 15 | 4 | 11 |
BB | 0 | 18 | 0 |
Voxel Dimension (mm3) | 4 × 4 × 4 | 4 × 4 × 4 | 4 × 4 × 4 |
3DPET/CT before RT | yes | yes | yes |
PET/CT System | - | - | - |
TF-64 | 15 | 4 | 11 |
BB | 0 | 18 | 0 |
Voxel Dimension (mm3) | 4 × 4 × 4 | 2 × 2 × 2 | 4 × 4 × 4 |
3DPET/CT during RT | yes | yes | yes |
PET/CT System | - | - | - |
TF-64 | 11 | 4 | 11 |
BB | 0 | 13 | 0 |
Voxel Dimension (mm3) | 4 × 4 × 4 | 2 × 2 × 2 | 4 × 4 × 4 |
3DPET/CT after RT | yes | yes | yes |
PET/CT System | - | - | - |
TF-64 | 4 | 0 | 11 |
BB | 0 | 5 | 0 |
Voxel Dimension (mm3) | 4 × 4 × 4 | 4 × 4 × 4 | 4 × 4 × 4 |
Time interval between 3D scans (days, mean ± SD, range) | (68 ± 92, 14–343) | (196 ± 340, 13–1123) | (140 ± 67, 42–271) |
Segmentation | Cohort 1 Manual | Cohort 1 COA | Cohort 3 Manual | All |
---|---|---|---|---|
Normal Distributed across 4D | 65 | 61 | 50 | 31 |
Comparable (4D vs. 3D) | 83 | 69 | 131 | 62 |
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Carles, M.; Fechter, T.; Radicioni, G.; Schimek-Jasch, T.; Adebahr, S.; Zamboglou, C.; Nicolay, N.H.; Martí-Bonmatí, L.; Nestle, U.; Grosu, A.L.; et al. FDG-PET Radiomics for Response Monitoring in Non-Small-Cell Lung Cancer Treated with Radiation Therapy. Cancers 2021, 13, 814. https://doi.org/10.3390/cancers13040814
Carles M, Fechter T, Radicioni G, Schimek-Jasch T, Adebahr S, Zamboglou C, Nicolay NH, Martí-Bonmatí L, Nestle U, Grosu AL, et al. FDG-PET Radiomics for Response Monitoring in Non-Small-Cell Lung Cancer Treated with Radiation Therapy. Cancers. 2021; 13(4):814. https://doi.org/10.3390/cancers13040814
Chicago/Turabian StyleCarles, Montserrat, Tobias Fechter, Gianluca Radicioni, Tanja Schimek-Jasch, Sonja Adebahr, Constantinos Zamboglou, Nils H. Nicolay, Luis Martí-Bonmatí, Ursula Nestle, Anca L. Grosu, and et al. 2021. "FDG-PET Radiomics for Response Monitoring in Non-Small-Cell Lung Cancer Treated with Radiation Therapy" Cancers 13, no. 4: 814. https://doi.org/10.3390/cancers13040814