Aims and objectives
Non–small cell lung cancer (NSCLC) comprises approximately 85% of all lung cancer cases [1].
Since its introduction in clinical practice,
immunotherapy revolutionized the treatment of NSCLC but nowadays there are no reliable clinical or biological markers that can predict response to immune checkpoint inhibitors.
Expression of Programmed-Death Ligand 1 (PD-L1) is considered unreliable to predict response to therapy due to intratumoral heterogeneous expression and non-standardized techniques of immune assay [2,3].Texture Analysis (TA) is a technique that can be applied on digital images to capture the...
Methods and materials
Patient Selection
We retrospectively evaluated baseline contrast-enhanced CT scans of 23 patients with Stage IIIb/IV NSCLC who were treated with a PD-1 Immune checkpoint Inhibitor (Nivolumab) from January 2015 to May 2017 at San Martino Policlinic,
University of Genoa.
All Patients received multiple lines of conventional chemotherapy and/or radiotherapy without clinical benefit before immunotherapy.
CT acquisition,
Reconstruction and Segmentation
CT scan data were acquired using the following parameters: 120 kVp,
100-300 mA,
5 mm slice thickness with 1.25 mm collimation.
CT scans were reformatted on...
Results
The accuracy of our models was 60% (AUC 0,60) for unfiltered images and 91,3% (AUC 0,92) (Fig.2),
56,5% (AUC 0,56) and 56,5% (AUC 0,59) for images filtered respectively with low (filter 1.0),
medium (filter 2.0) and high (filter 3.0) values.
Conclusion
Tang et Al [7] elaborated a radiomic signature that correlated with tumor immune microenvironment.
Our study lacks a pathological correlation but our predictive model can identify a specific radiological phenotype that is associated with a better OSin patients treated with immunotherapy for NSCLC.
Only the model with CT images filtered with a low value performed well in distinguish patients with increased OS: probably these parameters permit to markedly decrease noise,
a factor that could easily generate a so-called “pseudotexture”,
without losing information about texture.
Machine...
References
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Ten Haken RK Can radiomics personalise immunotherapy?
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2018 Sep;19(9):1138-1139.
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Han G,
Schalper KA,
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Quantitative assessment of the heterogeneity of PD-L1 expression in non-small-cell lung cancer.
JAMA Oncol 2016; 2: 46–54.
[4] M.
Strzelecki,
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Szczypinski,
A....