Utility of radiomic features in predicting clinical outcomes in stage II-III pancreatic cancer.

Authors

null

Haruka Itakura

Stanford University School of Medicine, Stanford, CA

Haruka Itakura , Qinmei Xu , Diego Toesca , Lucas Vitzthum , Arash Jamalian , Emil Schueler , Emel Alkim , J Richelcyn Baclay , Daniel Tandel Chang , George A. Fisher Jr.

Organizations

Stanford University School of Medicine, Stanford, CA, Mayo Clinic College of Medicine, Phoenix, AZ, Department of Radiation Oncology, Stanford University, Stanford, CA, The University of Texas MD Anderson Cancer Center, Houston, TX, Stanford University, Stanford, CA, University of Michigan, Ann Arbor, MI, Department of Medicine, Stanford University School of Medicine, Stanford, CA

Research Funding

Stanford Division of Oncology, Stanford Cancer Institute

Background: We identified computed tomography (CT)-derived radiomic features predictive of tumor progression within three months, then examined their ability to prognosticate overall survival (OS) along with clinical features in pancreatic cancer. We evaluated these features in patients with unresected pancreatic cancer who underwent stereotactic body radiation therapy (SBRT) in sequence with chemotherapy, but not surgery. Methods: In this retrospective study, we examined a cohort of 101 patients with stage II-III pancreatic cancer who underwent SBRT with sequential chemotherapy at a single institution (Stanford Health Care) between 1999-2020. From their pre-SBRT contrast-enhanced CT images with segmented tumors, delineating regions-of-interest, we extracted 900 radiomic (quantitative pixel-level imaging characteristic) features. In the first phase, we identified radiomic features that predicted rapid tumor progression within three months following SBRT. We divided the dataset into a training set (n = 53) for model development and a test set (n = 48) for evaluation. Using logistic regression with the Least Absolute Shrinkage and Selection Operator algorithm for feature selection and classification, we built a binary prediction model on the training set to identify patients at risk of progression within three months of SBRT. To fine-tune parameters, we performed five-fold cross-validation (CV) on the training set, repeating each set of parameters five times. We assessed model performance on the test set using the area under the curve (AUC). We selected the model with the best AUC, generating the predictive radiomic feature set. In the second phase, we conducted univariate and multivariate Cox regression analyses to assess the relationship between OS and individual clinical variables (age, sex, stage, vessel involvement, tumor location, performance status, body mass index, biological equivalent dose of radiation) and the radiomic feature set as high versus low risk. Results: Our cohort consisted of 48 men (mean age, 70 years ± 11 [SD]) and 53 women (mean age, 67 years ± 13 [SD]). From the first phase, 32 textural features comprised the radiomic feature set that best predicted rapid tumor progression, with mean AUCs of 0.852 (CV, n=53) and 0.814 (test, n=48). In the univariate Cox model, only the radiomic feature set was predictive of OS (hazard ratio, HR, 1.724, p=0.011). In the multivariate Cox model, radiomic features and age were significant predictors of OS, with HR of 1.819 (p=0.007) and 1.024 (p=0.024), respectively. Conclusions: CT-derived radiomic features predict rapid tumor progression following SBRT, confer nearly a twofold increase in mortality risk, and, along with patient age, enhance the identification of patients with stage II-III pancreatic cancer with poor OS.

HRP value
Radiomics - High Risk1.820.007
Age1.020.024
Pancreatic Head Tumor1.450.102
BED - Low1.310.224
Male1.270.284

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Abstract Details

Meeting

2024 ASCO Breakthrough

Session Type

Poster Session

Session Title

Poster Session A

Track

Gastrointestinal Cancer,Central Nervous System Tumors,Developmental Therapeutics,Genitourinary Cancer,Quality of Care,Healthcare Equity and Access to Care,Population Health,Viral-Mediated Malignancies

Sub Track

Omics for precision medicine

Citation

J Clin Oncol 42, 2024 (suppl 23; abstr 74)

DOI

10.1200/JCO.2024.42.23_suppl.74

Abstract #

74

Poster Bd #

E6

Abstract Disclosures

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