论著摘要 |【Radiomics-CT】肺癌立体定向烧蚀放射治疗后局部癌症复发的检测:医师检测能力与影像组学评估的对比(双语版)

2018-02-23 10:53:02 admin 0
标签:   影像组学 肺癌 CT 局部复发 辅助诊断

Detection of Local Cancer Recurrence After Stereotactic Ablative Radiation Therapy for Lung Cancer: Physician Performance Versus Radiomic Assessment.

发表日期: 2016.04.01   来源:Int J Radiat Oncol Biol Phys. 2016 Apr 1;94(5):1121-8.

作者:

Mattonen SA1, Palma DA2, Johnson C3 , Louie AV4, Landis M5, Rodrigues G4, Chan I5, Etemad-Rezai R5, Yeung TP1, Senan S6, Ward AD7.

作者介绍:

1. Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada; Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario, Canada.

2. Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada; Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario, Canada; Department of Oncology, The University of Western Ontario, London, Ontario, Canada. Electronic address: david.palma@lhsc.on.ca.

3. Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario, Canada.

4. Department of Oncology, The University of Western Ontario, London, Ontario, Canada.

5. Department of Diagnostic Radiology, London Health Sciences Centre, London, Ontario, Canada.

6. Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.

7. Department of Medical Biophysics, The University of Western Ontario, London, Ontario, Canada; Baines Imaging Research Laboratory, London Regional Cancer Program, London, Ontario, Canada; Department of Oncology, The University of Western Ontario, London, Ontario, Canada.

摘要

Abstact

目的

立体定向烧蚀放射治疗(SABR)是早期肺癌的指导治疗方案。然而,治疗后可能发生纤维化,使局部复发难以检测。这项研究的目的是评估医师及时检测局部复发的能力,并将医师的表现与影像组学工具进行比较。

Purpose

Stereotactic ablative radiation therapy (SABR) is a guideline-specified treatment option for early-stage lung cancer. However, significant posttreatment fibrosis can occur and obfuscate the detection of local recurrence. The goal of this study was to assess physician ability to detect timely local recurrence and to compare physician performance with a radiomics tool.

方法与材料

使用SABR治疗的45例患者进行治疗后计算机断层扫描(n = 182)(15例局部复发与30例无局部复发相匹配),用于评价医师和影像组学评估治疗反应的能力。扫描仪由3名胸外放射肿瘤科医师和3名胸放射科医师分别进行评分,所有医师对临床结果不知情。从相同的图像中提取影像组学特征。对医师评估人员的表现和影像组学特征评估进行对比。

Methods AND Materials

Posttreatment computed tomography (CT) scans (n=182) from 45 patients treated with SABR (15 with local recurrence matched to 30 with no local recurrence) were used to measure physician and radiomic performance in assessing response. Scans were individually scored by 3 thoracic radiation oncologists and 3 thoracic radiologists, all of whom were blinded to clinical outcomes. Radiomic features were extracted from the same images. Performances of the physician assessors and the radiomics signature were compared.

结果

考虑整个随访期间的所有CT扫描时,局部复发的医师评估灵敏度的中位数为83%(范围为67%-100%),特异度的中位数为75%(范围为67%-87%),当只有中等的观察者间一致性(κ= 0.54)并且时间为15.5个月检测复发的中间时间。在确定SABR后<6个月内复发早期预测时,医师将大部分图像评估为良性损伤/无复发,平均误差为35%,假阳性率(FPR)为1%,假阴性率(FNR)为99%。同时由5个图像外观特征组成的影像组学特征表现出优异的辨别力,受试者工作特性曲线下面积为0.85,分类误差为24%,FPR为24%,FNR为23%。

Results

When taking into account all CT scans during the whole follow-up period, median sensitivity for physician assessment of local recurrence was 83% (range, 67%-100%), and specificity was 75% (range, 67%-87%), with only moderate interobserver agreement (κ = 0.54) and a median time to detection of recurrence of 15.5 months. When determining the early prediction of recurrence within < 6 months after SABR, physicians assessed the majority of images as benign injury/no recurrence, with a mean error of 35%, false positive rate (FPR) of 1%, and false negative rate (FNR) of 99%. At the same time point, a radiomic signature consisting of 5 image-appearance features demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.85, classification error of 24%, FPR of 24%, and FNR of 23%.

结论

这些结果表明,影像组学可以检测与局部复发相关的但通常不被医师考虑的一些早期变化。该决策支持系统可能为SABR治疗后局部复发患者的早期补救治疗提供潜在帮助。

Conclusions

These results suggest that radiomics can detect early changes associated with local recurrence that are not typically considered by physicians. This decision support system could potentially allow for early salvage therapy of patients with local recurrence after SABR.

阅读原文:PMID: 26907916  DOI: 10.1016/j.ijrobp.2015.12.369


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