A FDG-PET radiomics signature detects esophageal squamous cell carcinoma patients who do not benefit from chemoradiation

Detection of patients with esophageal squamous cell carcinoma (ESCC) who do not benefit from standard chemoradiation (CRT) is an important medical need. Radiomics using 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising approach. In this retrospective study of 184 patients...

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Published in:	Scientific reports Vol. 10; no. 1; p. 17671
Main Authors:	Li, Yimin, Beck, Marcus, Päßler, Tom, Lili, Chen, Hua, Wu, Mai, Ha Dong, Amthauer, Holger, Biebl, Matthias, Thuss-Patience, Peter C., Berger, Jasmin, Stromberger, Carmen, Tinhofer, Ingeborg, Kruppa, Jochen, Budach, Volker, Hofheinz, Frank, Lin, Qin, Zschaeck, Sebastian
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 19-10-2020 Nature Portfolio
Subjects:	692/4028/67/1504/1477 692/4028/67/1857 692/4028/67/2321 692/53/2422 692/699/1503/1476 Adult Aged Aged, 80 and over Chemoradiotherapy Disease-Free Survival Esophageal Neoplasms - diagnostic imaging Esophageal Neoplasms - mortality Esophageal Neoplasms - therapy Esophageal Squamous Cell Carcinoma - diagnostic imaging Esophageal Squamous Cell Carcinoma - mortality Esophageal Squamous Cell Carcinoma - therapy Female Fluorodeoxyglucose F18 Humanities and Social Sciences Humans Kaplan-Meier Estimate Male Middle Aged multidisciplinary Positron Emission Tomography Computed Tomography - methods Retrospective Studies Science Science (multidisciplinary) Survival Analysis Treatment Failure
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Summary:	Detection of patients with esophageal squamous cell carcinoma (ESCC) who do not benefit from standard chemoradiation (CRT) is an important medical need. Radiomics using 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising approach. In this retrospective study of 184 patients with locally advanced ESCC. 152 patients from one center were grouped into a training cohort (n = 100) and an internal validation cohort (n = 52). External validation was performed with 32 patients treated at a second center. Primary endpoint was disease-free survival (DFS), secondary endpoints were overall survival (OS) and local control (LC). FDG-PET radiomics features were selected by Lasso-Cox regression analyses and a separate radiomics signature was calculated for each endpoint. In the training cohort radiomics signatures containing up to four PET derived features were able to identify non-responders in regard of all endpoints (DFS p < 0.001, LC p = 0.003, OS p = 0.001). After successful internal validation of the cutoff values generated by the training cohort for DFS (p = 0.025) and OS (p = 0.002), external validation using these cutoffs was successful for DFS (p = 0.002) but not for the other investigated endpoints. These results suggest that pre-treatment FDG-PET features may be useful to detect patients who do not respond to CRT and could benefit from alternative treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-020-74701-w