Abstract
PurposeTo investigate associations between imaging features of cholangiocarcinoma by visual assessment and texture analysis, which quantifies heterogeneity in tumor enhancement patterns, with molecular profiles based on hypoxia markers.MethodsThe institutional review board approved this HIPAA-compliant retrospective study of CT images of intrahepatic cholangiocarcinoma, obtained before surgery. Immunostaining for hypoxia markers (EGFR, VEGF, CD24, P53, MDM2, MRP-1, HIF-1α, CA-IX, and GLUT1) was performed on pre-treatment liver biopsies. Quantitative imaging phenotypes were determined by texture analysis with gray level co-occurrence matrixes. The correlations between quantitative imaging phenotypes, qualitative imaging features (measured by radiographic inspection alone), and expression levels of the hypoxia markers from the 25 tumors were assessed.ResultsTwenty-five patients were included with a median age of 62 years (range: 54–84). The median tumor size was 10.2 cm (range: 4–14), 10 (40%) were single tumors, and 90% were moderately differentiated. Positive immunostaining was recorded for VEGF in 67% of the cases, EGFR in 75%, and CD24 in 55%. On multiple linear regression analysis, quantitative imaging phenotypes correlated significantly with EGFR and VEGF expression levels (R2 = 0.4, p<0.05 and R2 = 0.2, p<0.05, respectively), while a trend was demonstrated with CD24 expression (R2 = 0.33, p = 0.1). Three qualitative imaging features correlated with VEGF and CD24 expression (P<0.05), however, none of the qualitative features correlated with the quantitative imaging phenotypes.ConclusionQuantitative imaging phenotypes, as defined by texture analysis, correlated with expression of specific markers of hypoxia, regardless of conventional imaging features.
Highlights
Radiogenomics is an emerging field focusing on establishing relationships between imaging phenotypes and molecular markers utilizing novel methods [1,2]
Positive immunostaining was recorded for vascular endothelial growth factor (VEGF) in 67% of the cases, epidermal growth factor receptor (EGFR) in 75%, and CD24 in 55%
On multiple linear regression analysis, quantitative imaging phenotypes correlated significantly with EGFR and VEGF expression levels (R2 = 0.4, p
Summary
Radiogenomics is an emerging field focusing on establishing relationships between imaging phenotypes and molecular markers utilizing novel methods [1,2]. Advances in radiogenomic imaging have the potential to contribute to clinical decision making through development of predictive and prognostic treatment algorithms and noninvasive disease surveillance This promising approach has several advantages compared to the current molecular profiling methods. ICC, an aggressive primary liver cancer with a low but clearly documented increase in incidence and mortality [8], is characterized by frequent over-expression of epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), as well as other pro-angiogenic and hypoxia mediators [9,10,11,12,13,14] These molecular features of ICC result in marked distortion of the microvascular phenotype, which combined with their frequent large size, make it an ideal tumor type for experimental studies that correlate quantitative imaging parameters and molecular profiling
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
