Abstract Archives of the RSNA, 2014
Role of Tumor Texture Analysis on CT Image and Tumor Metabolism Measured by FDG-PET in the Management of Non-small Cell Lung Cancer Patients
Presented on December 2, 2014
Presented as part of MIS-TUB: Molecular Imaging Tuesday Poster Discussions
Koichi Hayano MD, Presenter: Nothing to Disclose
Naveen Kulkarni MD, Abstract Co-Author: Nothing to Disclose
Fang Tian MD, Abstract Co-Author: Nothing to Disclose
Dushyant V. Sahani MD, Abstract Co-Author: Research Grant, General Electric Company
Aerobic glycolysis in cancer cells involves elevated glucose uptake. On the other hand, heterogeneity in the structure or blood supply is a well recognizes feature of malignancy. The purpose of this study is to compare computed tomography texture analysis (CTTA) with tumor metabolism measured by 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) and survival in non-small cell lung cancer (NSCLC) treated with combined therapy of nanoparticle albumin-bound paclitaxel (nab-paclitaxel), calboplatin and bevacizumab.
In the phase II clinical trial, 35 patients (17 M / 18 W; median age: 64.0 years) with unresectable or metastatic NSCLC treated with nab-paclitaxel, calboplatin and bevacizumab were enrolled. Median follow-up time was 12.5 months. FDG-PET and non-contrast enhanced (CE) CT were performed before the therapy. Tumor texture parameters including mean gray intensity (MGI), Entropy, mean of positive pixels (MPP) were measured on non-CECT images by a texture analysis software (TexRAD, Somerset, UK), where the filtration (spatial scale filter, SSF) extracted features of medium texture scale (SSF=4 mm in radius). Correlations of texture parameters with SUVmax were investigated, and those parameters were compared with overall survival (OS) using Cox regression and Kaplan-Meier analysis.
MGI and MPP showed a negative correlation with SUVmax (R=-0.472, P=0.008; R=-0.485, P=0.006; respectively). In univariate Cox regression analysis, SUVmax, MGI, MPP and Entropy showed significant correlations with OS (P=0.03, P=0.02, P=0.04, P=0.0008, respectively). In Kaplan-Meier analysis, higher MGI, MPP, lower SUVmax and Entropy associated with favorable OS (P=0.0008, P=0.0009, P=0.01, P=0.005, respectively). In multivariate analysis, Entropy was identified as an independent prognostic factor of NSCLC (P=0.01; hazards ratio, 4.14; 95% CI, 1.23-25.53) in comparison with SUVmax, MGI, and MPP.
Pre-therapeutic tumor texture parameter on non-CECT can serve as a predictive imaging biomarker reflecting tumor metabolism and survival in NSCLC patients treated with nab-paclitaxel, calboplatin and bevacizumab.
CT texture analysis can be a widely applicable noninvasive biomarker for predicting survival in non-small cell lung cancer patients, and it would help select an optimal therapy for those patients.
Role of Tumor Texture Analysis on CT Image and Tumor Metabolism Measured by FDG-PET in the Management of Non-small Cell Lung Cancer Patients. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015356.html