Abstract
ObjectivesTo investigate the capability of computed-tomography (CT) radiomic features to predict the therapeutic response of Esophageal Carcinoma (EC) to chemoradiotherapy (CRT).MethodsPretreatment contrast-enhanced CT images of 49 EC patients (33 responders, 16 nonresponders) who received with CRT were retrospectively analyzed. The region of tumor was contoured by two radiologists. A total of 214 features were extracted from the tumor region. Kruskal-Wallis test and receiver operating characteristic (ROC) analysis were performed to evaluate the capability of each feature on treatment response classification. Support vector machine (SVM) and artificial neural network (ANN) algorithms were used to build models for prediction of the treatment response. The statistical difference between the performances of the models was assessed using McNemar’s test.ResultsRadiomic-based classification showed significance in differentiating responders from nonresponders. Five features were found to discriminate nonresponders from responders (AUCs from 0.686 to 0.727). Considering these features, two features (Histogram2D_skewness: P = 0.015. Histogram2D_kurtosis: P = 0.039) were significant for differentiating SDs (stable disease) from PRs (partial response) and one feature (Histogram2D_skewness: P = 0.027) for differentiating SDs from CRs (complete response). Both classifiers showed potential in predicting the treatment response with higher accuracy (ANN: 0.972, SVM: 0.891). No statistically significant difference was observed in the performance of the two classifiers (P = 0.250).ConclusionsCT-based radiomic features can be used as imaging biomarkers to predict tumor response to CRT in EC patients.
Highlights
Esophageal carcinoma is the eighth most commonly occurring types of malignancy, including more than450.000 new cancer diagnoses yearly, and the sixth leading cause of cancer-related mortality with an estimated approximately 400.000 deaths every year [1]
CT-based radiomic features can be used as imaging biomarkers to predict tumor response to CRT in Esophageal Carcinoma (EC) patients
Most people are diagnosed with esophageal cancer present with locally www.impactjournals.com/oncotarget advanced disease, to which concurrent chemoradiotherapy has emerged as a standard treatment [2]
Summary
Esophageal carcinoma is the eighth most commonly occurring types of malignancy, including more than450.000 new cancer diagnoses yearly, and the sixth leading cause of cancer-related mortality with an estimated approximately 400.000 deaths every year [1]. Most people are diagnosed with esophageal cancer present with locally www.impactjournals.com/oncotarget advanced disease, to which concurrent chemoradiotherapy has emerged as a standard treatment [2]. Locally advanced esophageal cancer has only 5-year overall survival of 36-47% after the CRT [3,4,5]. Literatures showed that early selected patients with poor response to CRT may benefit from salvage surgery, with long-term survival [6, 7]. Identification of these patients prior to treatment would allow modification of their therapeutic plan and/or intensification of radiation dose to reduce unnecessary toxicity and improve prognosis
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