Assessment of treatment response during chemoradiation therapy for pancreatic cancer based on quantitative radiomic analysis of daily CTs: An exploratory studyReportar como inadecuado




Assessment of treatment response during chemoradiation therapy for pancreatic cancer based on quantitative radiomic analysis of daily CTs: An exploratory study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Purpose

In an effort for early assessment of treatment response, we investigate radiation induced changes in quantitative CT features of tumor during the delivery of chemoradiation therapy CRT for pancreatic cancer.

Methods

Diagnostic-quality CT data acquired daily during routine CT-guided CRT using a CT-on-rails for 20 pancreatic head cancer patients were analyzed. On each daily CT, the pancreatic head, the spinal cord and the aorta were delineated and the histograms of CT number CTN in these contours were extracted. Eight histogram-based radiomic metrics including the mean CTN MCTN, peak position, volume, standard deviation SD, skewness, kurtosis, energy and entropy were calculated for each fraction. Paired t-test was used to check the significance of the change of specific metric at specific time. GEE model was used to test the association between changes of metrics over time for different pathology responses.

Results

In general, CTN histogram in the pancreatic head but not in spinal cord changed during the CRT delivery. Changes from the 1st to the 26th fraction in MCTN ranged from -15.8 to 3.9 HU with an average of -4.7 HU p<0.001. Meanwhile the volume decreased, the skewness increased less skewed, and the kurtosis decreased less peaked. The changes of MCTN, volume, skewness, and kurtosis became significant after two weeks of treatment. Patient pathological response is associated with the changes of MCTN, SD, and skewness. In cases of good response, patients tend to have large reductions in MCTN and skewness, and large increases in SD and kurtosis.

Conclusions

Significant changes in CT radiomic features, such as the MCTN, skewness, and kurtosis in tumor were observed during the course of CRT for pancreas cancer based on quantitative analysis of daily CTs. These changes may be potentially used for early assessment of treatment response and stratification for therapeutic intensification.



Autor: Xiaojian Chen, Kiyoko Oshima, Diane Schott, Hui Wu, William Hall, Yingqiu Song, Yalan Tao, Dingjie Li, Cheng Zheng, Paul Knechtge

Fuente: http://plos.srce.hr/



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