Abstract
PurposeThe purpose of this study was to investigate the association between the radiomics features (RFs) extracted from a whole-tumor ADC map during the early treatment course and response to concurrent chemoradiotherapy (cCRT) in patients with esophageal squamous cell carcinoma (ESCC).MethodsPatients with ESCC who received concurrent chemoradiotherapy were enrolled in two hospitals. Whole-tumor ADC values and RFs were extracted from sequential ADC maps before treatment, after the 5th radiation, and after the 10th radiation, and the changes of ADC values and RFs were calculated as the relative difference between different time points. RFs were selected and further imported to a support vector machine classifier for building a radiomics signature. Radiomics signatures were obtained from both RFs extracted from pretreatment images and three sets of delta-RFs. Prediction models for different responders based on clinical characteristics and radiomics signatures were built up with logistic regression.ResultsPatients (n=76) from hospital 1 were randomly assigned to training (n=53) and internal testing set (n=23) in a ratio of 7 to 3. In addition, to further test the performance of the model, data from another institute (n=17) were assigned to the external testing set. Neither ADC values nor delta-ADC values were correlated with treatment response in the three sets. It showed a predictive effect to treatment response that the AUC values of the radiomics signature built from delta-RFs over the first 2 weeks were 0.824, 0.744, and 0.742 in the training, the internal testing, and the external testing set, respectively. Compared with the evaluated response, the performance of response prediction in the internal testing set was acceptable (p = 0.048).ConclusionsThe ADC map-based delta-RFs during the early course of treatment were effective to predict the response to cCRT in patients with ESCC.
Highlights
Worldwide, esophageal cancer ranks 7th in cancer incidence and 6th in mortality rate reported by the World Health Organization [1]
The purpose of this study was to investigate the association between the radiomics features (RFs) extracted from a whole-tumor apparent diffusion coefficient (ADC) map during the early treatment course and response to concurrent chemoradiotherapy in patients with esophageal squamous cell carcinoma (ESCC)
It showed a predictive effect to treatment response that the area under the curve (AUC) values of the radiomics signature built from delta-RFs over the first 2 weeks were 0.824, 0.744, and 0.742 in the training, the internal testing, and the external testing set, respectively
Summary
Esophageal cancer ranks 7th in cancer incidence and 6th in mortality rate reported by the World Health Organization [1]. Though concurrent chemoradiotherapy (cCRT) has become the prevalent treatment for local advanced ESCC, individual differences for therapeutic sensitivity still exist [5]. Response Evaluation Criteria in Solid Tumors (RECIST, version1.1) is the most widely used tool for assessing solid tumor response to nonsurgical treatment. It relies on imaging techniques, such as X-ray and computed tomography (CT), providing little information about the molecule, cell, histopathology, and biology [6]. Compared to these imaging modalities, magnetic resonance imaging (MRI) is able to precisely depict the histopathological layers of the esophageal wall in an ex vivo evaluation [7]. The utilization of the ADC value as an imaging biomarker is still controversial [11–13]
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