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- Title
Potential Added Value of PET/CT Radiomics for Survival Prognostication beyond AJCC 8th Edition Staging in Oropharyngeal Squamous Cell Carcinoma.
- Authors
Haider, Stefan P.; Zeevi, Tal; Baumeister, Philipp; Reichel, Christoph; Sharaf, Kariem; Forghani, Reza; Kann, Benjamin H.; Judson, Benjamin L.; Prasad, Manju L.; Burtness, Barbara; Mahajan, Amit; Payabvash, Seyedmehdi
- Abstract
Accurate risk-stratification can facilitate precision therapy in oropharyngeal squamous cell carcinoma (OPSCC). We explored the potential added value of baseline positron emission tomography (PET)/computed tomography (CT) radiomic features for prognostication and risk stratification of OPSCC beyond the American Joint Committee on Cancer (AJCC) 8th edition staging scheme. Using institutional and publicly available datasets, we included OPSCC patients with known human papillomavirus (HPV) status, without baseline distant metastasis and treated with curative intent. We extracted 1037 PET and 1037 CT radiomic features quantifying lesion shape, imaging intensity, and texture patterns from primary tumors and metastatic cervical lymph nodes. Utilizing random forest algorithms, we devised novel machine-learning models for OPSCC progression-free survival (PFS) and overall survival (OS) using "radiomics" features, "AJCC" variables, and the "combined" set as input. We designed both single- (PET or CT) and combined-modality (PET/CT) models. Harrell's C-index quantified survival model performance; risk stratification was evaluated in Kaplan–Meier analysis. A total of 311 patients were included. In HPV-associated OPSCC, the best "radiomics" model achieved an average C-index ± standard deviation of 0.62 ± 0.05 (p = 0.02) for PFS prediction, compared to 0.54 ± 0.06 (p = 0.32) utilizing "AJCC" variables. Radiomics-based risk-stratification of HPV-associated OPSCC was significant for PFS and OS. Similar trends were observed in HPV-negative OPSCC. In conclusion, radiomics imaging features extracted from pre-treatment PET/CT may provide complimentary information to the current AJCC staging scheme for survival prognostication and risk-stratification of HPV-associated OPSCC.
- Subjects
ALGORITHMS; CANCER patients; CERVIX uteri; COMPUTED tomography; COMPUTER simulation; LYMPH nodes; MACHINE learning; METASTASIS; PAPILLOMAVIRUS diseases; RISK assessment; SQUAMOUS cell carcinoma; SURVIVAL analysis (Biometry); POSITRON emission tomography; TUMOR markers; TUMOR classification; DISEASE progression; DESCRIPTIVE statistics; KAPLAN-Meier estimator; OROPHARYNGEAL cancer; RANDOM forest algorithms; DISEASE complications; DISEASE risk factors
- Publication
Cancers, 2020, Vol 12, Issue 7, p1778
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers12071778