Rationale and Objectives The aim of this study was to explore the use of texture features generated from liver computed tomographic (CT) datasets as potential image-based indicators of patient response to radioembolization (RE) with yttrium-90 (90Y) resin microspheres, an emerging locoregional therapy for advanced-stage liver cancer. Materials and Methods Overall post-therapy survival and percent change in serologic tumor marker at three months post-therapy represent the primary clinical outcomes in this study. Thirty advanced-stage liver cancer cases (primary and metastatic) treated with RE over a three year period were included. Texture signatures for tumor regions, which were delineated to reveal boundaries with normal regions, were computed from pre-treatment contrast-enhanced liver CT studies and evaluated for their ability to classify patient serologic response and survival. Results A series of systematic leave-one-out cross-validation studies using soft-margin support vector machine (SVM) classifiers showed hepatic tumor texton and local binary pattern (LBP) signatures both achieve high accuracy (96%) in discriminating subjects in terms of their serologic response. The image-based indicators were also accurate in classifying subjects by survival status (80% and 93% accuracy for texton and LBP signatures, respectively). Conclusions Hepatic texture signatures generated from tumor regions on pre-treatment triphasic CT studies were highly accurate in differentiating among subjects in terms of serologic response and survival. These image-based computational markers show promise as potential predictive tools in candidate evaluation for locoregional therapy such as RE.
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