skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy

Abstract

Purpose: To identify prognostic biomarkers in pancreatic cancer using high-throughput quantitative image analysis. Methods and Materials: In this institutional review board–approved study, we retrospectively analyzed images and outcomes for 139 locally advanced pancreatic cancer patients treated with stereotactic body radiation therapy (SBRT). The overall population was split into a training cohort (n=90) and a validation cohort (n=49) according to the time of treatment. We extracted quantitative imaging characteristics from pre-SBRT {sup 18}F-fluorodeoxyglucose positron emission tomography, including statistical, morphologic, and texture features. A Cox proportional hazard regression model was built to predict overall survival (OS) in the training cohort using 162 robust image features. To avoid over-fitting, we applied the elastic net to obtain a sparse set of image features, whose linear combination constitutes a prognostic imaging signature. Univariate and multivariate Cox regression analyses were used to evaluate the association with OS, and concordance index (CI) was used to evaluate the survival prediction accuracy. Results: The prognostic imaging signature included 7 features characterizing different tumor phenotypes, including shape, intensity, and texture. On the validation cohort, univariate analysis showed that this prognostic signature was significantly associated with OS (P=.002, hazard ratio 2.74), which improved upon conventional imaging predictors including tumor volume, maximummore » standardized uptake value, and total legion glycolysis (P=.018-.028, hazard ratio 1.51-1.57). On multivariate analysis, the proposed signature was the only significant prognostic index (P=.037, hazard ratio 3.72) when adjusted for conventional imaging and clinical factors (P=.123-.870, hazard ratio 0.53-1.30). In terms of CI, the proposed signature scored 0.66 and was significantly better than competing prognostic indices (CI 0.48-0.64, Wilcoxon rank sum test P<1e-6). Conclusion: Quantitative analysis identified novel {sup 18}F-fluorodeoxyglucose positron emission tomography image features that showed improved prognostic value over conventional imaging metrics. If validated in large, prospective cohorts, the new prognostic signature might be used to identify patients for individualized risk-adaptive therapy.« less

Authors:
 [1];  [2]; ; ;  [1];  [3]; ;  [1];  [4];  [1];  [2];  [4]
  1. Department of Radiation Oncology, Stanford University, Palo Alto, California (United States)
  2. (Japan)
  3. Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo (Japan)
  4. (United States)
Publication Date:
OSTI Identifier:
22648786
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOLOGICAL MARKERS; BIOMEDICAL RADIOGRAPHY; EMISSION; FORECASTING; IMAGE PROCESSING; MULTIVARIATE ANALYSIS; NEOPLASMS; PANCREAS; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; RADIOTHERAPY; REGRESSION ANALYSIS

Citation Formats

Cui, Yi, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, Song, Jie, Pollom, Erqi, Alagappan, Muthuraman, Shirato, Hiroki, Chang, Daniel T., Koong, Albert C., Stanford Cancer Institute, Stanford, California, Li, Ruijiang, E-mail: rli2@stanford.edu, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, and Stanford Cancer Institute, Stanford, California. Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.04.034.
Cui, Yi, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, Song, Jie, Pollom, Erqi, Alagappan, Muthuraman, Shirato, Hiroki, Chang, Daniel T., Koong, Albert C., Stanford Cancer Institute, Stanford, California, Li, Ruijiang, E-mail: rli2@stanford.edu, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, & Stanford Cancer Institute, Stanford, California. Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy. United States. doi:10.1016/J.IJROBP.2016.04.034.
Cui, Yi, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, Song, Jie, Pollom, Erqi, Alagappan, Muthuraman, Shirato, Hiroki, Chang, Daniel T., Koong, Albert C., Stanford Cancer Institute, Stanford, California, Li, Ruijiang, E-mail: rli2@stanford.edu, Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo, and Stanford Cancer Institute, Stanford, California. Thu . "Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy". United States. doi:10.1016/J.IJROBP.2016.04.034.
@article{osti_22648786,
title = {Quantitative Analysis of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Identifies Novel Prognostic Imaging Biomarkers in Locally Advanced Pancreatic Cancer Patients Treated With Stereotactic Body Radiation Therapy},
author = {Cui, Yi and Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo and Song, Jie and Pollom, Erqi and Alagappan, Muthuraman and Shirato, Hiroki and Chang, Daniel T. and Koong, Albert C. and Stanford Cancer Institute, Stanford, California and Li, Ruijiang, E-mail: rli2@stanford.edu and Global Institution for Collaborative Research and Education, Hokkaido University, Sapporo and Stanford Cancer Institute, Stanford, California},
abstractNote = {Purpose: To identify prognostic biomarkers in pancreatic cancer using high-throughput quantitative image analysis. Methods and Materials: In this institutional review board–approved study, we retrospectively analyzed images and outcomes for 139 locally advanced pancreatic cancer patients treated with stereotactic body radiation therapy (SBRT). The overall population was split into a training cohort (n=90) and a validation cohort (n=49) according to the time of treatment. We extracted quantitative imaging characteristics from pre-SBRT {sup 18}F-fluorodeoxyglucose positron emission tomography, including statistical, morphologic, and texture features. A Cox proportional hazard regression model was built to predict overall survival (OS) in the training cohort using 162 robust image features. To avoid over-fitting, we applied the elastic net to obtain a sparse set of image features, whose linear combination constitutes a prognostic imaging signature. Univariate and multivariate Cox regression analyses were used to evaluate the association with OS, and concordance index (CI) was used to evaluate the survival prediction accuracy. Results: The prognostic imaging signature included 7 features characterizing different tumor phenotypes, including shape, intensity, and texture. On the validation cohort, univariate analysis showed that this prognostic signature was significantly associated with OS (P=.002, hazard ratio 2.74), which improved upon conventional imaging predictors including tumor volume, maximum standardized uptake value, and total legion glycolysis (P=.018-.028, hazard ratio 1.51-1.57). On multivariate analysis, the proposed signature was the only significant prognostic index (P=.037, hazard ratio 3.72) when adjusted for conventional imaging and clinical factors (P=.123-.870, hazard ratio 0.53-1.30). In terms of CI, the proposed signature scored 0.66 and was significantly better than competing prognostic indices (CI 0.48-0.64, Wilcoxon rank sum test P<1e-6). Conclusion: Quantitative analysis identified novel {sup 18}F-fluorodeoxyglucose positron emission tomography image features that showed improved prognostic value over conventional imaging metrics. If validated in large, prospective cohorts, the new prognostic signature might be used to identify patients for individualized risk-adaptive therapy.},
doi = {10.1016/J.IJROBP.2016.04.034},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 96,
place = {United States},
year = {Thu Sep 01 00:00:00 EDT 2016},
month = {Thu Sep 01 00:00:00 EDT 2016}
}