Abstract

PurposeThe aim was to investigate the advantages of dosiomic and radiomic features over traditional dose-volume histogram (DVH) features for predicting the development of radiation pneumonitis (RP), to validate the generalizability of dosiomic and radiomic features by using features selected from an esophageal cancer dataset and to use these features with a lung cancer dataset.Materials and MethodsA dataset containing 101 patients with esophageal cancer and 93 patients with lung cancer was included in this study. DVH and dosiomic features were extracted from 3D dose distributions. Radiomic features were extracted from pretreatment CT images. Feature selection was performed using only the esophageal cancer dataset. Four predictive models for RP (DVH, dosiomic, radiomic and dosiomic + radiomic models) were compared on the esophageal cancer dataset. We further used a lung cancer dataset for the external validation of the selected dosiomic and radiomic features from the esophageal cancer dataset. The performance of the predictive models was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve (ROCAUC) and the AUC of the precision recall curve (PRAUC) metrics.ResultThe ROCAUCs and PRAUCs of the DVH, dosiomic, radiomic and dosiomic + radiomic models on esophageal cancer dataset were 0.67 ± 0.11 and 0.75 ± 0.10, 0.71 ± 0.10 and 0.77 ± 0.09, 0.71 ± 0.11 and 0.79 ± 0.09, and 0.75 ± 0.10 and 0.81 ± 0.09, respectively. The predictive performance of the dosiomic- and radiomic-based models was significantly higher than that of the DVH-based model with respect to esophageal cancer. The ROCAUCs and PRAUCs of the DVH, dosiomic, radiomic and dosiomic + radiomic models on the lung cancer dataset were 0.64 ± 0.18 and 0.37 ± 0.20, 0.67 ± 0.17 and 0.37 ± 0.20, 0.67 ± 0.16 and 0.45 ± 0.23, and 0.68 ± 0.16 and 0.44 ± 0.22, respectively. On the lung cancer dataset, the predictive performance of the radiomic and dosiomic + radiomic models was significantly higher than that of the DVH-based model. However, the PRAUC of the dosiomic-based model showed no significant difference relative to the corresponding RP prediction performance on the lung cancer dataset.ConclusionThe results suggested that dosiomic and CT radiomic features could improve RP prediction in thoracic radiotherapy. Dosiomic and radiomic feature knowledge might be transferrable from esophageal cancer to lung cancer.

Highlights

  • In thoracic radiation therapy, organs at risk, such as the lungs, are the limiting factors of radiation treatment due to radiation toxicity

  • The selected features for the dose volume histograms (DVHs), dosiomic and radiomic groups are shown in Supplementary Table 1

  • For the DVH features selected from the esophageal cancer dataset, only V45 had a p-value less than 0.1 in the univariate analysis of the lung cancer dataset

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Summary

Introduction

Organs at risk, such as the lungs, are the limiting factors of radiation treatment due to radiation toxicity. Many studies have tried to develop RP prediction models based on dose volume histograms (DVHs) and/or the clinical profiles of patients [1–3]. Quantitative image features such as the dosiomic (quantitative features of dose distribution) and/or radiomic features of computed tomography (CT) images have been reported to improve the performance of prediction models for radiation toxicity [4–8]. Dosiomic features contain more dose distribution information than DVH features and have been shown to be able to improve toxicity prediction in radiation therapy. RP prediction models for lung cancer have been shown to benefit from the use of radiomic features obtained from CT images [6–8]. The quantitative imaging features of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT were previously studied in esophageal cancer patients [12]. Only a subset of radiomics features in CT images was explored

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