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Peeken, J.C. ; Asadpour, R.* ; Specht, K.* ; Chen, E.Y.* ; Klymenko, O.* ; Akinkuoroye, V.* ; Hippe, D.S.* ; Spraker, M.B.* ; Schaub, S.K.* ; Dapper, H.* ; Knebel, C.* ; Mayr, N.A.* ; Gersing, A.S.* ; Woodruff, H.C.* ; Lambin, P.* ; Nyflot, M.J.* ; Combs, S.E.

MRI-based delta-radiomics predicts pathologic complete response in high-grade soft-tissue sarcoma patients treated with neoadjuvant therapy.

Radiother. Oncol. 164, 73-82 (2021)
Postprint DOI PMC
Open Access Green
PURPOSE: In high-grade soft-tissue sarcomas (STS) the standard of care encompasses multimodal therapy regimens. While there is a growing body of evidence for prognostic pretreatment radiomic models, we hypothesized that temporal changes in radiomic features following neoadjuvant treatment ("delta-radiomics") may be able to predict the pathological complete response (pCR). METHODS: MRI scans (T1-weighted with fat-saturation and contrast-enhancement (T1FSGd) and T2-weighted with fat-saturation (T2FS)) of patients with STS of the extremities and trunk treated with neoadjuvant therapy were gathered from two independent institutions (training: 103, external testing: 53 patients). pCR was defined as < 5% viable cells. After segmentation and preprocessing, 105 radiomic features were extracted. Delta-radiomic features were calculated by subtraction of features derived from MRI scans obtained before and after neoadjuvant therapy. After feature reduction, machine learning modeling was performed in 100 iterations of 3-fold nested cross-validation. Delta-radiomic models were compared with single timepoint models in the testing cohort. RESULTS: The combined delta-radiomic models achieved the best area under the receiver operating characteristic curve (AUC) of 0.75. Pre-therapeutic tumor volume was the best conventional predictor (AUC 0.70). The T2FS-based delta-radiomic model had the most balanced classification performance with a balanced accuracy of 0.69. Delta-radiomic models achieved better reproducibility than single timepoint radiomic models, RECIST or the peri-therapeutic volume change. Delta-radiomic models were significantly associated with survival in multivariate Cox regression. CONCLUSION: This exploratory analysis demonstrated that MRI-based delta-radiomics improves prediction of pCR over tumor volume and RECIST. Delta-radiomics may one day function as a biomarker for personalized treatment adaptations.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Mri ; Delta Radiomics ; Machine Learning ; Neoadjuvant Radiotherapy ; Response Prediction ; Soft-tissue Sarcoma
ISSN (print) / ISBN 0167-8140
e-ISSN 1879-0887
Journal Radiotherapy and Oncology
Quellenangaben Volume: 164, Issue: , Pages: 73-82 Article Number: , Supplement: ,
Publisher Elsevier
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Radiation Medicine (IRM)