Prognostic Value of [18F]-FDG PET/CT Radiomics Combined with Sarcopenia Status among Patients with Advanced Gastroesophageal Cancer
by
, , , ,
Ricarda Hinzpeter
1,*
,
Seyed Ali Mirshahvalad
1
,
Roshini Kulanthaivelu
1,
Claudia Ortega
1,
Ur Metser
1,
Zhihui A. Liu
2,
Elena Elimova
3,
Rebecca K. S. Wong
4,
Jonathan Yeung
5,
Raymond Woo-Jun Jang
4 and
Patrick Veit-Haibach
1 1
Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
2
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
3
Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
4
Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
5
Division of Thoracic Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
*
Author to whom correspondence should be addressed.
Cancers 2022, 14(21), 5314; https://doi.org/10.3390/cancers14215314
Submission received: 26 September 2022
/
Revised: 26 October 2022
/
Accepted: 26 October 2022
/
Published: 28 October 2022
(This article belongs to the Topic F-18 FDG PET/CT Imaging)
Simple Summary
Increasing knowledge of outcome prognostication, derived from various clinical and imaging-derived parameters, has the potential for pretreatment risk stratification, allowing clinicians to deliver more patient specific treatment tailored to individual risk. Our study indicates that a prognostic model, combining clinical parameter, PET and CT radiomics with sarcopenic status, derived from standard of care clinical 18F-FDG-PET/CT improves outcome prognostication among patients with advanced, metastatic esophageal and gastroesophageal cancer.
Abstract
We investigated, whether 18[18F]-FDG PET/CT-derived radiomics combined with sarcopenia measurements improves survival prognostication among patients with advanced, metastatic gastroesophageal cancer. In our study, 128 consecutive patients with advanced, metastatic esophageal and gastroesophageal cancer (n = 128; 26 females; 102 males; mean age 63.5 ± 11.7 years; age range: 29–91 years) undergoing 18[18F]-FDG PET/CT for staging between November 2008 and December 2019 were included. Segmentation of the primary tumor and radiomics analysis derived from PET and CT images was performed semi-automatically with a commonly used open-source software platform (LIFEX, Version 6.30, lifexsoft.org). Patients’ nutritional status was determined by measuring the skeletal muscle index (SMI) at the level of L3 on the CT component. Univariable and multivariable analyses were performed to establish a survival prediction model including radiomics, clinical data, and SMI score. Univariable Cox proportional hazards model revealed ECOG (<0.001) and bone metastasis (p = 0.028) to be significant clinical parameters for overall survival (OS) and progression free survival (PFS). Age (p = 0.017) was an additional prognostic factor for OS. Multivariable analysis showed improved prognostication for overall and progression free survival when adding sarcopenic status, PET and CT radiomics to the model with clinical parameters only. PET and CT radiomics derived from hybrid 18[18F]-FDG PET/CT combined with sarcopenia measurements and clinical parameters may improve survival prediction among patients with advanced, metastatic gastroesophageal cancer.
Keywords:
18[18F]-FDG PET/CT; radiomics; sarcopenia; gastroesophageal cancer
