Prediction of treatment response to transarterial radioembolization of liver metastases: Radiomics analysis of pre-treatment cone-beam CT: A proof of concept study. (2021)

• Record Type: Journal Article
• Authors: Kobe, Adrian; Zgraggen, Juliana; Messmer, Florian; Puippe, Gilbert; Sartoretti, Thomas; Alkadhi, Hatem; Pfammatter, Thomas; Mannil, Manoj
• Is Part Of: European journal of radiology open. Volume 8(2021)
• Publication Date: 2021
• Subjects: 99mTc-MAA 99mtechnetium labelled macroaggregated albumin -- 90Y-microspheres Yttrium-90-microspheres -- ANN Artificial neural network -- CBCT Cone-beam Computed Tomography -- CR Complete response -- CT Computed tomography -- DICOM Digital Imaging and Communications in Medicine -- GLCM Gray-level co-occurrence matrix -- GLDM Gray-level dependence matrix -- GLRLM Gray-level run length matrix -- GLSZM Gray-level size zone matrix -- ICC Intraclass-correlation coefficient -- MR Magnetic resonance -- NGTDM Neighboring gray tone difference matrix -- PD Progressive disease -- PET Positron emission tomography -- PR Partial response -- SD Stable disease -- TACE Transarterial chemoembolization -- TARE Transarterial radioembolization; Radiomics -- Transarterial radioembolization -- Machine learning -- Cone-Beam CT; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2021.100375
• Languages: English
• ISSNs: 2352-0477

Abstract

Abstract: Purpose: To investigate the potential of texture analysis and machine learning to predict treatment response to transarterial radioembolization (TARE) on pre-interventional cone-beam computed tomography (CBCT) images in patients with liver metastases. Materials and Methods: In this IRB-approved retrospective single-center study 36 patients with a total of 104 liver metastases (56 % male, mean age 61.1 ± 13 years) underwent CBCT prior to TARE and follow-up imaging 6 months after therapy. Treatment response was evaluated according to RECIST version 1.1 and dichotomized into disease control (partial response/stable disease) versus disease progression (progressive disease). After target lesion segmentation, 104 radiomics features corresponding to seven different feature classes were extracted with the pyRadiomics package. After dimension reduction machine learning classifications were performed on a custom artificial neural network (ANN). Ten-fold cross validation on a previously unseen test data set was performed. Results: The average administered cumulative activity from TARE was 1.6 Gbq (± 0.5 Gbq). At a mean follow-up of 5.9 ± 0.8 months disease control was achieved in 82 % of metastases. After dimension reduction, 15 of 104 (15 %) texture analysis features remained for further analysis. On a previously unseen set of liver metastases the Multilayer Perceptron ANN yielded a sensitivity of 94.2 %, specificity of 67.7 % and an area-under-the receiver operating characteristics curve of 0.85. Conclusion: Our study indicates that texture analysis-based machine learning may has potential to predict treatment response to TARE using pre-treatment CBCT images of patients with liver metastases with high accuracy.