Predicting hypoxia status using a combination of contrast-enhanced computed tomography and (18)F-fluorodeoxyglucose positron emission tomography radiomics features Journal Article


Authors: Crispin-Ortuzar, M.; Apte, A.; Grkovski, M.; Oh, J. H.; Lee, N. Y.; Schöder, H.; Humm, J. L.; Deasy, J. O.
Article Title: Predicting hypoxia status using a combination of contrast-enhanced computed tomography and (18)F-fluorodeoxyglucose positron emission tomography radiomics features
Abstract: Background and purpose: Hypoxia is a known prognostic factor in head and neck cancer. Hypoxia imaging PET radiotracers such as 18F-FMISO are promising but not widely available. The aim of this study was therefore to design a surrogate for 18F-FMISO TBRmax based on 18F-FDG PET and contrast-enhanced CT radiomics features, and to study its performance in the context of hypoxia-based patient stratification. Methods: 121 lesions from 75 head and neck cancer patients were used in the analysis. Patients received pre-treatment 18F-FDG and 18F-FMISO PET/CT scans. 79 lesions were used to train a cross-validated LASSO regression model based on radiomics features, while the remaining 42 were held out as an internal test subset. Results: In the training subset, the highest AUC (0.873±0.008) was obtained from a signature combining CT and 18F-FDG PET features. The best performance on the unseen test subset was also obtained from the combined signature, with an AUC of 0.833, while the model based on the 90th percentile of 18F-FDG uptake had a test AUC of 0.756. Conclusion: A radiomics signature built from 18F-FDG PET and contrast-enhanced CT features correlates with 18F-FMISO TBRmax in head and neck cancer patients, providing significantly better performance with respect to models based on 18F-FDG PET only. Such a biomarker could potentially be useful to personalize head and neck cancer treatment at centers for which dedicated hypoxia imaging PET radiotracers are unavailable. © 2017 Elsevier B.V.
Keywords: major clinical study; cancer patient; antineoplastic agent; retrospective study; hypoxia; head and neck cancer; contrast enhancement; fluorodeoxyglucose f 18; iohexol; 1 fluoro 3 (2 nitro 1 imidazolyl) 2 propanol f 18; pet; tumor hypoxia; chemoradiotherapy; fdg; receiver operating characteristic; clinical trial (topic); fmiso; human; priority journal; article; radiomics; positron emission tomography-computed tomography; omics
Journal Title: Radiotherapy and Oncology
Volume: 127
Issue: 1
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2018-04-01
Start Page: 36
End Page: 42
Language: English
DOI: 10.1016/j.radonc.2017.11.025
PROVIDER: scopus
PMCID: PMC5924729
PUBMED: 29273260
DOI/URL:
Notes: Article -- Export Date: 1 June 2018 -- Source: Scopus
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MSK Authors
  1. Nancy Y. Lee
    582 Lee
  2. Heiko Schoder
    307 Schoder
  3. John Laurence Humm
    352 Humm
  4. Jung Hun Oh
    119 Oh
  5. Joseph Owen Deasy
    314 Deasy
  6. Aditya Apte
    124 Apte