Quantitative imaging features of pretreatment CT predict volumetric response to chemotherapy in patients with colorectal liver metastases Journal Article


Authors: Creasy, J. M.; Midya, A.; Chakraborty, J.; Adams, L. B.; Gomes, C.; Gonen, M.; Seastedt, K. P.; Sutton, E. J.; Cercek, A.; Kemeny, N. E.; Shia, J.; Balachandran, V. P.; Kingham, T. P.; Allen, P. J.; DeMatteo, R. P.; Jarnagin, W. R.; D’Angelica, M. I.; Do, R. K. G.; Simpson, A. L.
Article Title: Quantitative imaging features of pretreatment CT predict volumetric response to chemotherapy in patients with colorectal liver metastases
Abstract: Objectives: This study investigates whether quantitative image analysis of pretreatment CT scans can predict volumetric response to chemotherapy for patients with colorectal liver metastases (CRLM). Methods: Patients treated with chemotherapy for CRLM (hepatic artery infusion (HAI) combined with systemic or systemic alone) were included in the study. Patients were imaged at baseline and approximately 8 weeks after treatment. Response was measured as the percentage change in tumour volume from baseline. Quantitative imaging features were derived from the index hepatic tumour on pretreatment CT, and features statistically significant on univariate analysis were included in a linear regression model to predict volumetric response. The regression model was constructed from 70% of data, while 30% were reserved for testing. Test data were input into the trained model. Model performance was evaluated with mean absolute prediction error (MAPE) and R2. Clinicopatholologic factors were assessed for correlation with response. Results: 157 patients were included, split into training (n = 110) and validation (n = 47) sets. MAPE from the multivariate linear regression model was 16.5% (R2 = 0.774) and 21.5% in the training and validation sets, respectively. Stratified by HAI utilisation, MAPE in the validation set was 19.6% for HAI and 25.1% for systemic chemotherapy alone. Clinical factors associated with differences in median tumour response were treatment strategy, systemic chemotherapy regimen, age and KRAS mutation status (p < 0.05). Conclusion: Quantitative imaging features extracted from pretreatment CT are promising predictors of volumetric response to chemotherapy in patients with CRLM. Pretreatment predictors of response have the potential to better select patients for specific therapies. Key Points: • Colorectal liver metastases (CRLM) are downsized with chemotherapy but predicting the patients that will respond to chemotherapy is currently not possible. • Heterogeneity and enhancement patterns of CRLM can be measured with quantitative imaging. • Prediction model constructed that predicts volumetric response with 20% error suggesting that quantitative imaging holds promise to better select patients for specific treatments. © 2018, European Society of Radiology.
Keywords: colorectal neoplasms; liver; models, statistical; multidetector computed tomography; prognosis
Journal Title: European Radiology
Volume: 29
Issue: 1
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2019-01-01
Start Page: 458
End Page: 467
Language: English
DOI: 10.1007/s00330-018-5542-8
PROVIDER: scopus
PMCID: PMC6301122
PUBMED: 29922934
DOI/URL:
Notes: Eur. Radiol. -- Export Date: 2 January 2019 -- Article -- CODEN: EURAE -- Source: Scopus
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MSK Authors
  1. Ronald P DeMatteo
    599 DeMatteo
  2. Mithat Gonen
    713 Gonen
  3. Jinru Shia
    459 Shia
  4. Peter Allen
    440 Allen
  5. William R Jarnagin
    590 Jarnagin
  6. Kinh Gian Do
    115 Do
  7. T Peter Kingham
    288 Kingham
  8. Nancy Kemeny
    357 Kemeny
  9. Elizabeth Jane Sutton
    26 Sutton
  10. Amber L Simpson
    51 Simpson
  11. Lauryn Brittney Adams
    5 Adams
  12. John Creasy
    9 Creasy
  13. Abhishek Midya
    9 Midya
  14. Camilla Gomes
    1 Gomes