Computed tomography image texture: A noninvasive prognostic marker of hepatic recurrence after hepatectomy for metastatic colorectal cancer Journal Article


Authors: Simpson, A. L.; Doussot, A.; Creasy, J. M.; Adams, L. B.; Allen, P. J.; DeMatteo, R. P.; Gönen, M.; Kemeny, N. E.; Kingham, T. P.; Shia, J.; Jarnagin, W. R.; Do, R. K. G.; D’Angelica, M. I.
Article Title: Computed tomography image texture: A noninvasive prognostic marker of hepatic recurrence after hepatectomy for metastatic colorectal cancer
Abstract: Background: Recurrence after resection of colorectal liver metastases (CRLMs) occurs in up to 75% of patients. Preoperative prediction of hepatic recurrence may inform therapeutic strategies at the time of initial resection. Texture analysis (TA) is an established technique that quantifies pixel intensity variations (heterogeneity) on cross-sectional imaging. We hypothesized that tumoral and parenchymal changes that are predictive of overall survival (OS) and recurrence in the future liver remnant (FLR) can be detected using TA on preoperative computed tomography (CT) images. Methods: Patients who underwent resection for CRLM between 2003 and 2007 with appropriate preoperative CT scans were included (n = 198) in this retrospective study. Texture features extracted from the tumor and FLR, and clinicopathologic variables, were incorporated into a multivariable survival model. Results: Quantitative imaging features of the FLR were an independent predictor of both OS and hepatic disease–free survival (HDFS). Tumor texture showed significant association with OS. TA of the FLR allowed patient stratification into two groups, with significantly different risks of hepatic recurrence (hazard ratio 2.09, 95% confidence interval 1.33–3.28; p = 0.001). Patients with homogeneous parenchyma had approximately twice the risk of hepatic recurrence (41 vs. 20%). Conclusion: TA of the tumor and FLR are independently associated with OS, and TA of the FLR is independently associated with HDFS. Patients with homogeneous parenchyma had a significantly higher risk of hepatic recurrence. Preoperative TA of the liver represents a potential biomarker to identify patients at risk of liver recurrence after resection for CRLM. © 2017, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 24
Issue: 9
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2017-09-01
Start Page: 2482
End Page: 2490
Language: English
DOI: 10.1245/s10434-017-5896-1
PROVIDER: scopus
PMCID: PMC5553273
PUBMED: 28560599
DOI/URL:
Notes: Article -- Export Date: 1 September 2017 -- Source: Scopus
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MSK Authors
  1. Ronald P DeMatteo
    627 DeMatteo
  2. Mithat Gonen
    782 Gonen
  3. Jinru Shia
    536 Shia
  4. Peter Allen
    479 Allen
  5. William R Jarnagin
    649 Jarnagin
  6. Kinh Gian Do
    146 Do
  7. T Peter Kingham
    340 Kingham
  8. Nancy Kemeny
    437 Kemeny
  9. Amber L Simpson
    58 Simpson
  10. Lauryn Brittney Adams
    5 Adams
  11. Alexandre Florent Doussot
    15 Doussot
  12. John Creasy
    12 Creasy