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.

Hayano, K, Kulkarni, N, Tian, F, Sahani, D, 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