A deep-learning radiomics model for predicting survival in early-stage non-small cell lung cancer.

Authors

Tafadzwa Chaunzwa

Tafadzwa Lawrence Chaunzwa

Computational Imaging and Bioinformatics Laboratory, Harvard Medical School, Boston, MA

Tafadzwa Lawrence Chaunzwa , David C. Christiani , Michael Lanuti , Andrea Shafer , Nancy Diao , Raymond H. Mak , Hugo Aerts

Organizations

Computational Imaging and Bioinformatics Laboratory, Harvard Medical School, Boston, MA, Harvard T.H. Chan School of Public Health, Boston, MA, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, Brigham Womens Hospital/Dana Farber Cancer Institute, Boston, MA, Department of Radiation Oncology and Radiology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

Research Funding

NIH

Background: There is a growing body of evidence suggesting radiomic phenotypes can augment prognostic power, when used in combination with clinical features and tumor genomic profiles in lung cancer. In this study we present a deep-learning model that can act as a non-invasive prognostic biomarker in patients with Stage-I Non-Small Cell Lung Cancer (NSCLC). Our model would be able to assign patients to short term or long term survival groups, based on CT characteristics. Methods: Pretreatment CT studies were retrieved for 299 patients who underwent surgery for Stage-I NSCLC at MGH between 2004-2010. Image pre-processing included manual tumor identification, and isotropic rescaling of CT data. Further data curation resulted in a final cohort of 186 patients. Median follow-up from time of diagnosis was 2.9 years and 9.7% of patients were deceased at 2 years. To mitigate bias against a low probability event (mortality), data augmentation was performed yielding 242 50x50 pixel patches to feed into our model. A pre-trained 16 layer deep neural network (VGG-16) was used to perform visual recognition and data analysis. Fine-tuning of the last two convolutional blocks and a fully-connected classifier was performed with a training set of 144 labeled CT scans, matched to one of two groups based on 2 year survival. 34 samples were used for initial cross-validation. Data containing variations of imaging scanners and protocols were used in training to create a model that is robust for the variations. Results: Our model learned to classify patients with long term vs short term survival in an independent validation set of 64 samples with 75% accuracy and AUC = 0.798. In comparison, a multivariate linear regression model of conventional clinical prognostic factors (age, gender, tumor stage, histology, and smoking status) had a lower predictive performance (AUC = 0.665). Event rates were balanced between training and independent-validation groups. Conclusions: These findings suggest that Artificial Intelligence-enhanced radiomic feature extraction and predictive modeling can aid the clinician in assessing the benefits of treatment for patients with early-stage NSCLC.

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers

Track

Lung Cancer

Sub Track

Local-Regional Non–Small Cell Lung Cancer

Citation

J Clin Oncol 36, 2018 (suppl; abstr 8528)

DOI

10.1200/JCO.2018.36.15_suppl.8528

Abstract #

8528

Poster Bd #

134

Abstract Disclosures

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