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Radiomics Analysis of 3D Dose Distributions to Predict Toxicity of Radiotherapy for Cervical Cancer

Radiation Oncology Department, University Hospital, CHRU Morvan, 2 avenue Foch, CEDEX, 29609 Brest, France
LaTIM, INSERM, UMR 1101, Univ Brest, 29200 Brest, France
Radiation Oncology Department, Cornouaille Hospital, 29000 Quimper, France
Clinical Oncology Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, Hammersmith, London W6 8RF, UK
Department of Cancer and Surgery, Imperial College London, London SW6 4NE, UK
Author to whom correspondence should be addressed.
Equally contributed.
Academic Editor: Gianluca Ingrosso
J. Pers. Med. 2021, 11(5), 398;
Received: 26 March 2021 / Revised: 8 May 2021 / Accepted: 10 May 2021 / Published: 11 May 2021
(This article belongs to the Special Issue Stereotactic Body Radiotherapy)
Standard treatment for locally advanced cervical cancer (LACC) is chemoradiotherapy followed by brachytherapy. Despite radiation therapy advances, the toxicity rate remains significant. In this study, we compared the prediction of toxicity events after radiotherapy for locally advanced cervical cancer (LACC), based on either dose-volume histogram (DVH) parameters or the use of a radiomics approach applied to dose maps at the voxel level. Toxicity scores using the Common Terminology Criteria for Adverse Events (CTCAE v4), spatial dose distributions, and usual clinical predictors for the toxicity of 102 patients treated with chemoradiotherapy followed by brachytherapy for LACC were used in this study. In addition to usual DVH parameters, 91 radiomic features were extracted from rectum, bladder and vaginal 3D dose distributions, after discretization into a fixed bin width of 1 Gy. They were evaluated for predictive modelling of rectal, genitourinary (GU) and vaginal toxicities (grade ≥ 2). Logistic Normal Tissue Complication Probability (NTCP) models were derived using clinical parameters only or combinations of clinical, DVH and radiomics. For rectal acute/late toxicities, the area under the curve (AUC) using clinical parameters was 0.53/0.65, which increased to 0.66/0.63, and 0.76/0.87, with the addition of DVH or radiomics parameters, respectively. For GU acute/late toxicities, the AUC increased from 0.55/0.56 (clinical only) to 0.84/0.90 (+DVH) and 0.83/0.96 (clinical + DVH + radiomics). For vaginal acute/late toxicities, the AUC increased from 0.51/0.57 (clinical only) to 0.58/0.72 (+DVH) and 0.82/0.89 (clinical + DVH + radiomics). The predictive performance of NTCP models based on radiomics features was higher than the commonly used clinical and DVH parameters. Dosimetric radiomics analysis is a promising tool for NTCP modelling in radiotherapy. View Full-Text
Keywords: radiomics; cervical cancer; toxicity; radiotherapy; NTCP radiomics; cervical cancer; toxicity; radiotherapy; NTCP
MDPI and ACS Style

Lucia, F.; Bourbonne, V.; Visvikis, D.; Miranda, O.; Gujral, D.M.; Gouders, D.; Dissaux, G.; Pradier, O.; Tixier, F.; Jaouen, V.; Bert, J.; Hatt, M.; Schick, U. Radiomics Analysis of 3D Dose Distributions to Predict Toxicity of Radiotherapy for Cervical Cancer. J. Pers. Med. 2021, 11, 398.

AMA Style

Lucia F, Bourbonne V, Visvikis D, Miranda O, Gujral DM, Gouders D, Dissaux G, Pradier O, Tixier F, Jaouen V, Bert J, Hatt M, Schick U. Radiomics Analysis of 3D Dose Distributions to Predict Toxicity of Radiotherapy for Cervical Cancer. Journal of Personalized Medicine. 2021; 11(5):398.

Chicago/Turabian Style

Lucia, François, Vincent Bourbonne, Dimitris Visvikis, Omar Miranda, Dorothy M. Gujral, Dominique Gouders, Gurvan Dissaux, Olivier Pradier, Florent Tixier, Vincent Jaouen, Julien Bert, Mathieu Hatt, and Ulrike Schick. 2021. "Radiomics Analysis of 3D Dose Distributions to Predict Toxicity of Radiotherapy for Cervical Cancer" Journal of Personalized Medicine 11, no. 5: 398.

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