Abstract
Simple SummarySkull-base chordomas (SBC) are rare tumours with unfavourable outcomes, even when undergoing advanced treatments such as carbon-ion radiotherapy (CIRT). By retrospectively analysing imaging (MRI, CT), treatment (dose maps) and clinical information available before treatment, the potential use of radiomics and dosiomics for risk modelling targeting SBC treated with CIRT was explored. Despite the small sample size, dosiomic features appear to be promising factors related to local control in SBC, with worse outcomes being associated to higher dose heterogeneity. Risk models exploiting all sources of information showed slightly inferior but good performance, suggesting that multi-parametric approaches are worth being pursued for patient risk stratification. This study is put forward as groundwork for radiomic analyses targeting SBC in CIRT.Skull-base chordoma (SBC) can be treated with carbon ion radiotherapy (CIRT) to improve local control (LC). The study aimed to explore the role of multi-parametric radiomic, dosiomic and clinical features as prognostic factors for LC in SBC patients undergoing CIRT. Before CIRT, 57 patients underwent MR and CT imaging, from which tumour contours and dose maps were obtained. MRI and CT-based radiomic, and dosiomic features were selected and fed to two survival models, singularly or by combining them with clinical factors. Adverse LC was given by in-field recurrence or tumour progression. The dataset was split in development and test sets and the models’ performance evaluated using the concordance index (C-index). Patients were then assigned a low- or high-risk score. Survival curves were estimated, and risk groups compared through log-rank tests (after Bonferroni correction α = 0.0083). The best performing models were built on features describing tumour shape and dosiomic heterogeneity (median/interquartile range validation C-index: 0.80/024 and 0.79/0.26), followed by combined (0.73/0.30 and 0.75/0.27) and CT-based models (0.77/0.24 and 0.64/0.28). Dosiomic and combined models could consistently stratify patients in two significantly different groups. Dosiomic and multi-parametric radiomic features showed to be promising prognostic factors for LC in SBC treated with CIRT.
Highlights
Particle therapy makes use of charged particles such as protons or carbon ions and is increasingly being adopted worldwide, with over 50 facilities built in the last ten years [1]
Dosiomic and multi-parametric radiomic features showed to be promising prognostic factors for local control (LC) in Skull-base chordoma (SBC) treated with carbon ion radiotherapy (CIRT)
Imaging (T1w-MRI, T2w-MRI, CT), treatment and clinical data was retrospectively collected for 57 SBC patients treated with CIRT
Summary
Particle therapy makes use of charged particles such as protons or carbon ions and is increasingly being adopted worldwide, with over 50 facilities built in the last ten years [1]. Carbon ion radiotherapy (CIRT) is limited to specialized centres, it shows higher geometrical selectivity and increased radiobiological effectiveness with respect to proton and conventional X-ray radiotherapy, being indicated for treating radioresistant and deep-seated tumours [2], such as chordomas. The limited phenotypic characterization of SBC prevents an optimal patient stratification to improve treatment outcomes. In this context, the growing availability of imaging data can be favourably exploited as a source of prognostic factors [8,9], with studies in the literature supporting the predictive power of the appearance of chordomas on diagnostic imaging, such as CT and MRI [10]. Qualitative imaging factors are being complemented by quantitative ones, such as radiomic features [11]
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