Abstract
To investigate the prognostic value of peri-tumoral radiomics features of pre-treatment PET/CT images in patients with head and neck cancer. 166 patients from 4 centers (111 for training and 55 for external independent testing) were retrospectively analyzed. 11 regions were used for feature extraction, (1) Intra-tumoral region (Intra) was first dilated radially along the edge by 3, 6, 9, 12 and 15 mm to obtain (2) 5 solid combined regions (noted as Comb_3, 6, 9, 12, and 15, respectively), and (3) 5 hollow annular regions with equal ring width of 3 mm were then generated as peri-tumoral regions (noted as Peri_3, 6, 9, 12 and 15, respectively). 92 individual/integrated models were constructed by using features from Clinical alone, CT or PET alone, Clinical+PET, Clinical+CT, PET+CT, Clinical+PET+CT, Intra+Peri, Clinical+Intra+Peri and Clinical+PET+CT (Intra+Peri). In individual models, only 4 models showed p<; 0.05 (PET_Peri_3 and PET_Comb_6 for distant metastasis (DM) prediction, Clinical and PET_Peri_6 for death prediction). In integrated models, Clinical+CT (Intra+Peri_6), PET (Intra+Peri_3) and Clinical+PET_Peri_6 achieved the best performance for the prediction of local recurrence (LR), DM and death with AUC of 0.75, 0.80 and 0.87, C-index of 0.71, 0.80 and 0.83, p-value of 0.003, 0.008 and 0.001, respectively. Peri-tumoral regions that located closer to the intra-tumoral region (Peri_3 and Peri_6) showed better performance compared to those located further. The integration of intra-tumoral and peri-tumoral radiomics features achieved better performance than either of them alone, PET and CT radiomics features also provided complementary information to clinical features.
Highlights
The incidence of head and neck (H&N) cancer ranks 7th in the world of malignant tumors, with about 885,045 new cases in 2018 [1]
The remaining 3 models are constructed by two modalities, either PET+CT or Clinical+PET, namely Clinical+PET_Peri_3, PET+CT(Intra) and PET+CT(Peri_3) with p-value of 0.032, 0.022 and
When Peri_6 features were further involved, Clinical+CT (Intra+Peri_6) achieved the highest AUC of 0.75, Concordance index (C-index) of 0.71 and Specificity of 0.84 among other models. Features retained in this model and their weights are given in Table 3, there are 4 clinical features, 3 CT_Intra features and 3 CT_Peri_6 features, 5/6 of the texture features are extracted from the wavelet decomposition
Summary
The incidence of head and neck (H&N) cancer (arising in nasopharynx, oropharynx, and hypopharynx etc.) ranks 7th in the world of malignant tumors, with about 885,045 new cases in 2018 [1]. The five-year survival rate is about 65% [2], [3], local recurrence (LR) and distant metastasis (DM). The associate editor coordinating the review of this manuscript and approving it for publication was Xiao-Sheng Si. are the main causes of treatment failure and death [4]. PET/CT has been used as an important tool for diagnosis, prognosis, and staging in H&N cancer [5], [6]. Radiomics is emerging as a quantitative measure of intra-tumoral heterogeneity by extracting high-throughput features [7]–[10]. Most radiomics studies regarding the prognosis of H&N cancer have demonstrated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
