Nav: Home

Researchers use radiomics to predict who will benefit from chemotherapy

March 20, 2019

OAK BROOK, Ill. (March 20, 2019) - Using data from computed tomography (CT) images, researchers may be able to predict which lung cancer patients will respond to chemotherapy, according to a new study published in the journal Radiology: Artificial Intelligence.

Platinum-based chemotherapy is typically the first-line treatment of advanced-stage non-small cell lung cancer (NSCLC). However, only about one in four patients responds well to this treatment. Currently, there is no way to predict which patients will benefit most from chemotherapy.

CT exams are routinely used for tumor staging and monitoring treatment response. Using a field of study called radiomics, researchers can extract quantitative, or measurable, data from CT images that can reveal disease characteristics not visible in the images alone.

"Our aim in this study was to determine whether an early prediction of response to chemotherapy is possible by using computer-extracted measurements of patterns both within and outside the lung nodule, along with the shape of the nodule, on baseline CT scans," said Mohammadhadi Khorrami, M.S., a Ph.D. candidate from the Department of Biomedical Engineering, Case Western Reserve University School of Engineering in Cleveland, Ohio, who, along with Monica Khunger, M.D., from the Department of Internal Medicine at Cleveland Clinic, led the study.

The researchers set out to identify the role of radiomic texture features--both within and around the lung tumor--in predicting time to progression and overall survival, as well as response to chemotherapy in patients with NSCLC.

"This is the first study to demonstrate that computer-extracted patterns of heterogeneity, or diversity, from outside the tumor were predictive of response to chemotherapy," Dr. Khunger said. "This is very critical because it could allow for predicting in advance of therapy which patients with lung cancer are likely to respond or not. This, in turn, could help identify patients who are likely to not respond to chemotherapy for alternative therapies such as radiation or immunotherapy."

They analyzed data from 125 patients who had been treated with pemetrexed-based platinum doublet chemotherapy at Cleveland Clinic. The patients were divided randomly into two sets with an equal number of responders and non-responders in the training set. The training set comprised 53 patients with NSCLC, and the validation set comprised 72 patients.

A computer analyzed the CT images of lung cancer to identify unique patterns of heterogeneity both inside and outside the tumor. These patterns were then compared between CT scans of patients who did and did not respond to chemotherapy. These feature patterns were then used to train a machine learning classifier to identify the likelihood that a lung cancer patient would respond to chemotherapy.

"When we looked at patterns inside the tumor, we got an accuracy of 0.68. But when we looked inside and outside, the accuracy went up to 0.77," Khorrami said.

The results showed that the radiomic features derived from within the tumor and the area around the tumor were able to distinguish patients who responded to chemotherapy from those who did not. In addition, the radiomic features predicted time to progression and overall survival.

"Despite the large number of studies in the CT-radiomics space, the immediate surrounding tumor area, or the peritumoral region, has remained relatively unexplored," Khorrami said. "Our results showed clear evidence of the role of peritumoral texture patterns in predicting response and time to progression after chemotherapy."

Although the researchers did not explicitly study the basis for the identified radiomic features around the tumor, they hypothesize that these patterns reflect increased fibrotic content in chemotherapy-compliant tumors.

According to Khorrami, the radiomic data derived from CT images can also potentially help identify those patients who are at elevated risk for recurrence and who might benefit from more intensive observation and follow-up.
-end-
"Combination of Peri- and Intratumoral Radiomic Features on Baseline CT Scans Predicts Response to Chemotherapy in Lung Adenocarcinoma." Collaborating with Drs. Khorrami and Khunger were Alexia Zagouras, M.D., Pradnya Patil, M.D., Rajat Thawani, M.D., Kaustav Bera, M.D., Prabhakar Rajiah, M.D., Pingfu Fu, Ph.D., Vamsidhar Velcheti, M.D., and Anant Madabhushi, Ph.D.

Radiology: Artificial Intelligence is edited by Charles E. Kahn Jr., M.D., University of Pennsylvania (Penn) Perelman School of Medicine, Philadelphia, and owned and published by the Radiological Society of North America, Inc.

RSNA is an association of over 53,400 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on lung cancer, visit RadiologyInfo.org.

Radiological Society of North America

Related Lung Cancer Articles:

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Lung transplant patients face elevated lung cancer risk
In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.
Proposed cancer treatment may boost lung cancer stem cells, study warns
Epigenetic therapies -- targeting enzymes that alter what genes are turned on or off in a cell -- are of growing interest in the cancer field as a way of making a cancer less aggressive or less malignant.
Are you at risk for lung cancer?
This question isn't only for people who've smoked a lot.
Better equipped in the fight against lung cancer
Lung cancer is the third most common type of cancer in Germany and the disease affects both men and women.
New liquid biopsy-based cancer model reveals data on deadly lung cancer
Small cell lung cancer (SCLC) accounts for 14 percent of all lung cancers and is often rapidly resistant to chemotherapy resulting in poor clinical outcomes.
Cancer drug leads to 'drastic decrease' in HIV infection in lung cancer patient
Doctors in France have found the first evidence that a cancer drug may be able to eradicate HIV-infected cells in humans.
Air pollution is associated with cancer mortality beyond lung cancer
A large scale epidemiological study associates some air pollutants with kidney, bladder and colorectal cancer death.
Free lung-cancer screening in the Augusta area finds more than double the cancer rate of previous screenings
The first year of free lung cancer screening in the Augusta, Ga., area found more than double the rate seen in a previous large, national study as well as a Massachusetts-based screening for this No.
Lung cancer may go undetected in kidney cancer patients
Could lung cancer be hiding in kidney cancer patients? Researchers with the Harold C.
More Lung Cancer News and Lung Cancer Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Risk
Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at Radiolab.org/donate.