MRI radiomic features are associated with survival in melanoma brain metastases treated with immune checkpoint inhibitors Journal Article


Authors: Bhatia, A.; Birger, M.; Veeraraghavan, H.; Um, H.; Tixier, F.; McKenney, A. S.; Cugliari, M.; Caviasco, A.; Bialczak, A.; Malani, R.; Flynn, J.; Zhang, Z.; Yang, T. J.; Santomasso, B. D.; Shoushtari, A. N.; Young, R. J.
Article Title: MRI radiomic features are associated with survival in melanoma brain metastases treated with immune checkpoint inhibitors
Abstract: BACKGROUND: Melanoma brain metastases historically portend a dismal prognosis, but recent advances in immune checkpoint inhibitors (ICIs) have been associated with durable responses in some patients. There are no validated imaging biomarkers associated with outcomes in patients with melanoma brain metastases receiving ICIs. We hypothesized that radiomic analysis of magnetic resonance images (MRIs) could identify higher-order features associated with survival. METHODS: Between 2010 and 2019, we retrospectively reviewed patients with melanoma brain metastases who received ICI. After volumes of interest were drawn, several texture and edge descriptors, including first-order, Haralick, Gabor, Sobel, and Laplacian of Gaussian (LoG) features were extracted. Progression was determined using Response Assessment in Neuro-Oncology Brain Metastases. Univariate Cox regression was performed for each radiomic feature with adjustment for multiple comparisons followed by Lasso regression and multivariate analysis. RESULTS: Eighty-eight patients with 196 total brain metastases were identified. Median age was 63.5 years (range, 19-91 y). Ninety percent of patients had Eastern Cooperative Oncology Group performance status of 0 or 1 and 35% had elevated lactate dehydrogenase. Sixty-three patients (72%) received ipilimumab, 11 patients (13%) received programmed cell death protein 1 blockade, and 14 patients (16%) received nivolumab plus ipilimumab. Multiple features were associated with increased overall survival (OS), and LoG edge features best explained the variation in outcome (hazard ratio: 0.68, P = 0.001). In multivariate analysis, a similar trend with LoG was seen, but no longer significant with OS. Findings were confirmed in an independent cohort. CONCLUSION: Higher-order MRI radiomic features in patients with melanoma brain metastases receiving ICI were associated with a trend toward improved OS. © The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Keywords: brain metastases; intratumoral heterogeneity; imaging biomarkers; immune checkpoint inhibitors; mri radiomic features
Journal Title: Neuro-Oncology
Volume: 21
Issue: 12
ISSN: 1522-8517
Publisher: Oxford University Press  
Date Published: 2019-12-01
Start Page: 1578
End Page: 1586
Language: English
DOI: 10.1093/neuonc/noz141
PUBMED: 31621883
PROVIDER: scopus
PMCID: PMC7145582
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    427 Zhang
  2. Robert J Young
    228 Young
  3. Jonathan T Yang
    166 Yang
  4. Rachna Malani
    38 Malani
  5. Ankush Bhatia
    18 Bhatia
  6. Jessica Flynn
    182 Flynn
  7. Florent Tixier
    11 Tixier
  8. Hyemin Um
    13 Um
  9. Maxwell Louis Birger
    3 Birger