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Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach

In the era of artificial intelligence and precision medicine, the use of quantitative imaging methodological approaches could improve the cancer patient’s therapeutic approaches. Specifically, our pilot study aims to explore whether CT texture features on both baseline and first post-treatment contr...

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Autores principales: Guerrisi, Antonino, Russillo, Michelangelo, Loi, Emiliano, Ganeshan, Balaji, Ungania, Sara, Desiderio, Flora, Bruzzaniti, Vicente, Falcone, Italia, Renna, Davide, Ferraresi, Virginia, Caterino, Mauro, Solivetti, Francesco Maria, Cognetti, Francesco, Morrone, Aldo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529867/
https://www.ncbi.nlm.nih.gov/pubmed/34692481
http://dx.doi.org/10.3389/fonc.2021.704607
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author Guerrisi, Antonino
Russillo, Michelangelo
Loi, Emiliano
Ganeshan, Balaji
Ungania, Sara
Desiderio, Flora
Bruzzaniti, Vicente
Falcone, Italia
Renna, Davide
Ferraresi, Virginia
Caterino, Mauro
Solivetti, Francesco Maria
Cognetti, Francesco
Morrone, Aldo
author_facet Guerrisi, Antonino
Russillo, Michelangelo
Loi, Emiliano
Ganeshan, Balaji
Ungania, Sara
Desiderio, Flora
Bruzzaniti, Vicente
Falcone, Italia
Renna, Davide
Ferraresi, Virginia
Caterino, Mauro
Solivetti, Francesco Maria
Cognetti, Francesco
Morrone, Aldo
author_sort Guerrisi, Antonino
collection PubMed
description In the era of artificial intelligence and precision medicine, the use of quantitative imaging methodological approaches could improve the cancer patient’s therapeutic approaches. Specifically, our pilot study aims to explore whether CT texture features on both baseline and first post-treatment contrast-enhanced CT may act as a predictor of overall survival (OS) and progression-free survival (PFS) in metastatic melanoma (MM) patients treated with the PD-1 inhibitor Nivolumab. Ninety-four lesions from 32 patients treated with Nivolumab were analyzed. Manual segmentation was performed using a free-hand polygon approach by drawing a region of interest (ROI) around each target lesion (up to five lesions were selected per patient according to RECIST 1.1). Filtration-histogram-based texture analysis was employed using a commercially available research software called TexRAD (Feedback Medical Ltd, London, UK; https://fbkmed.com/texrad-landing-2/) Percentage changes in texture features were calculated to perform delta-radiomics analysis. Texture feature kurtosis at fine and medium filter scale predicted OS and PFS. A higher kurtosis is correlated with good prognosis; kurtosis values greater than 1.11 for SSF = 2 and 1.20 for SSF = 3 were indicators of higher OS (fine texture: 192 HR = 0.56, 95% CI = 0.32–0.96, p = 0.03; medium texture: HR = 0.54, 95% CI = 0.29–0.99, p = 0.04) and PFS (fine texture: HR = 0.53, 95% CI = 0.29–0.95, p = 0.03; medium texture: HR = 0.49, 209 95% CI = 0.25–0.96, p = 0.03). In delta-radiomics analysis, the entropy percentage variation correlated with OS and PFS. Increasing entropy indicates a worse outcome. An entropy variation greater than 5% was an indicator of bad prognosis. CT delta-texture analysis quantified as entropy predicted OS and PFS. Baseline CT texture quantified as kurtosis also predicted survival baseline. Further studies with larger cohorts are mandatory to confirm these promising exploratory results.
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spelling pubmed-85298672021-10-22 Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach Guerrisi, Antonino Russillo, Michelangelo Loi, Emiliano Ganeshan, Balaji Ungania, Sara Desiderio, Flora Bruzzaniti, Vicente Falcone, Italia Renna, Davide Ferraresi, Virginia Caterino, Mauro Solivetti, Francesco Maria Cognetti, Francesco Morrone, Aldo Front Oncol Oncology In the era of artificial intelligence and precision medicine, the use of quantitative imaging methodological approaches could improve the cancer patient’s therapeutic approaches. Specifically, our pilot study aims to explore whether CT texture features on both baseline and first post-treatment contrast-enhanced CT may act as a predictor of overall survival (OS) and progression-free survival (PFS) in metastatic melanoma (MM) patients treated with the PD-1 inhibitor Nivolumab. Ninety-four lesions from 32 patients treated with Nivolumab were analyzed. Manual segmentation was performed using a free-hand polygon approach by drawing a region of interest (ROI) around each target lesion (up to five lesions were selected per patient according to RECIST 1.1). Filtration-histogram-based texture analysis was employed using a commercially available research software called TexRAD (Feedback Medical Ltd, London, UK; https://fbkmed.com/texrad-landing-2/) Percentage changes in texture features were calculated to perform delta-radiomics analysis. Texture feature kurtosis at fine and medium filter scale predicted OS and PFS. A higher kurtosis is correlated with good prognosis; kurtosis values greater than 1.11 for SSF = 2 and 1.20 for SSF = 3 were indicators of higher OS (fine texture: 192 HR = 0.56, 95% CI = 0.32–0.96, p = 0.03; medium texture: HR = 0.54, 95% CI = 0.29–0.99, p = 0.04) and PFS (fine texture: HR = 0.53, 95% CI = 0.29–0.95, p = 0.03; medium texture: HR = 0.49, 209 95% CI = 0.25–0.96, p = 0.03). In delta-radiomics analysis, the entropy percentage variation correlated with OS and PFS. Increasing entropy indicates a worse outcome. An entropy variation greater than 5% was an indicator of bad prognosis. CT delta-texture analysis quantified as entropy predicted OS and PFS. Baseline CT texture quantified as kurtosis also predicted survival baseline. Further studies with larger cohorts are mandatory to confirm these promising exploratory results. Frontiers Media S.A. 2021-10-07 /pmc/articles/PMC8529867/ /pubmed/34692481 http://dx.doi.org/10.3389/fonc.2021.704607 Text en Copyright © 2021 Guerrisi, Russillo, Loi, Ganeshan, Ungania, Desiderio, Bruzzaniti, Falcone, Renna, Ferraresi, Caterino, Solivetti, Cognetti and Morrone https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Guerrisi, Antonino
Russillo, Michelangelo
Loi, Emiliano
Ganeshan, Balaji
Ungania, Sara
Desiderio, Flora
Bruzzaniti, Vicente
Falcone, Italia
Renna, Davide
Ferraresi, Virginia
Caterino, Mauro
Solivetti, Francesco Maria
Cognetti, Francesco
Morrone, Aldo
Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach
title Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach
title_full Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach
title_fullStr Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach
title_full_unstemmed Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach
title_short Exploring CT Texture Parameters as Predictive and Response Imaging Biomarkers of Survival in Patients With Metastatic Melanoma Treated With PD-1 Inhibitor Nivolumab: A Pilot Study Using a Delta-Radiomics Approach
title_sort exploring ct texture parameters as predictive and response imaging biomarkers of survival in patients with metastatic melanoma treated with pd-1 inhibitor nivolumab: a pilot study using a delta-radiomics approach
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529867/
https://www.ncbi.nlm.nih.gov/pubmed/34692481
http://dx.doi.org/10.3389/fonc.2021.704607
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