A FDG-PET radiomics signature detects esophageal squamous cell carcinoma patients who do not benefit from chemoradiation

Abstract

Detection of patients with esophageal squamous cell carcinoma (ESCC) who do not benefit from standard chemoradiation (CRT) is an important medical need. Radiomics using 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising approach. In this retrospective study of 184 patients with locally advanced ESCC. 152 patients from one center were grouped into a training cohort (n = 100) and an internal validation cohort (n = 52). External validation was performed with 32 patients treated at a second center. Primary endpoint was disease-free survival (DFS), secondary endpoints were overall survival (OS) and local control (LC). FDG-PET radiomics features were selected by Lasso-Cox regression analyses and a separate radiomics signature was calculated for each endpoint. In the training cohort radiomics signatures containing up to four PET derived features were able to identify non-responders in regard of all endpoints (DFS p < 0.001, LC p = 0.003, OS p = 0.001). After successful internal validation of the cutoff values generated by the training cohort for DFS (p = 0.025) and OS (p = 0.002), external validation using these cutoffs was successful for DFS (p = 0.002) but not for the other investigated endpoints. These results suggest that pre-treatment FDG-PET features may be useful to detect patients who do not respond to CRT and could benefit from alternative treatment.

Clinical Perspectives for 18F-FDG PET Imaging in Pediatric Oncology: Μetabolic Tumor Volume and Radiomics

“…The reported findings in pediatric sarcomas follow mostly the first evidence data concerning the prediction of response to neoadjuvant chemotherapy by PET metabolic and radiomic features in carcinomas, the typical histologic type of adulthood solid cancers [ 99 , 100 , 101 ]. In comparison, sarcomas are rare in adulthood; they develop prevalently in soft-tissue, and include more different histologic subtypes than pediatric sarcomas.…”

KIF4A enhanced cell proliferation and migration via Hippo signaling and predicted a poor prognosis in esophageal squamous cell carcinoma

“…Esophageal squamous cell carcinoma is a malignant tumor of the digestive tract 16 which occurs in the esophageal epithelium. Because ESCC does not become specifically manifested in the early stage, most patients in the sample were in the middle and late stages when they visited the doctor 17 . Therefore, early diagnosis and assessment of disease progression trend are effective ways to improve the prognosis of ESCC patients.…”

Value of PET imaging for radiation therapy

“…Besides contributing to improved biological tumour delineation, PET parameters are additionally associated with favourable outcomes in neoadjuvant and definitive treatment settings. This holds true for baseline PET-parameters but even more so for interim PET parameters [88][89][90][91][92]. Novel PET-parameters (e.g.…”