Abstract:
Background:The purpose of this study is to develop a radiomics approach to predict brain metastasis (BM) for stage III/IV ALK-positive non-small cell lung cancer (NSCLC) patients. Methods:Patients with ALK-positive III/IV NSCLC from 2014 to 2017 were enrolled retrospectively. Their pretreatment thoracic CT images were collected, and the gross tumor volume (GTV) was defined by two experienced radiation oncologists. An in-house feature extraction code-set was performed based on MATLAB 2015b (Mathworks, Natick, MA, USA) in patients' CT images to extract features. Patients were randomly divided into training set and test set (4:1) by using createDataPartition function in caret package. A test-retest in RIDER NSCLC dataset was performed to identify stable radiomics features. LASSO Cox regression and a leave-one-out cross-validation were conducted to identify optimal features for the logistic regression model to evaluate the predictive value of radiomics feature(s) for BM. Furthermore, extended validation for the radiomics feature(s) and Cox regression analyses which combined radiomics feature(s) and treatment elements were implemented to predict the risk of BM during follow-up. Results:In total, 132 patients were included, among which 27 patients had pretreatment BM. The median follow-up time was 11.8 (range, 0.1-65.2) months. In the training set, one radiomics feature (W_GLCM_LH_Correlation) showed discrimination ability of BM (P value =0.014, AUC =0.687, 95% CI: 0.551-0.824, specificity =83.5%, sensitivity =57.1%). It also exhibited reposeful performance in the test set (AUC =0.642, 95% CI: 0.501-0.783, specificity =60.0%, sensitivity =83.3%). Those 105 patients without pretreatment BM were divided into stage III (n=57) and stage IV (n=48) groups. The radiomics feature (W_GLCM_LH_Correlation) had moderate performance to predict BM during/after treatment in separate groups (stage III: AUC =0.682, 95% CI: 0.537-0.826, specificity =64.4%, sensitivity =75.0%; stage IV: AUC =0.653, 95% CI: 0.503-0.804, specificity =70.4%, sensitivity =75.0%). Meanwhile, stage III patients could be divided into low risk and high risk groups for BM during surveillance according to Cox regression analysis (log-rank P value =0.021). Conclusions:We identified one wavelet texture feature derived from pretreatment thoracic CT that presented potential in predicting BM in stage III/IV ALK-positive NSCLC patients. This could be beneficial to risk stratification for such patients. Further investigation is necessary to include expanded sample size investigation and external multicenter validation.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Xu X,Huang L,Chen J,Wen J,Liu D,Cao J,Wang J,Fan Mdoi
10.21037/jtd.2019.11.01subject
Has Abstractpub_date
2019-11-01 00:00:00pages
4516-4528issue
11eissn
2072-1439issn
2077-6624pii
jtd-11-11-4516journal_volume
11pub_type
杂志文章abstract:Background:To investigate the capability of radiomic analysis using T2-weighted (T2W) and spectral attenuated inversion-recovery T2-weighted (SPAIR T2W) magnetic resonance imaging (MRI) for predicting the therapeutic response of esophageal squamous cell carcinoma (ESCC) to chemoradiotherapy (CRT). Methods:Pretreatment...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.123
更新日期:2018-04-01 00:00:00
abstract::Cone beam computed tomography (CBCT) is a well-established imaging modality with numerous proven applications across multiple clinical disciplines. More recently, CBCT has emerged as an important imaging tool for bronchoscopists, primarily used during transbronchial biopsy of peripheral pulmonary lesions (PPLS). For t...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd-20-2382
更新日期:2020-12-01 00:00:00
abstract:Background:The development of minimally invasive surgical approaches has revolutionized surgical care and greatly improved surgical outcomes. This study aimed to evaluate the clinical effectiveness of a powered vascular stapler (PVS) during video-assisted thoracoscopic surgery (VATS) lobectomy. Methods:This prospectiv...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.04.89
更新日期:2019-05-01 00:00:00
abstract::The lumen diameter reduction after percutaneous coronary intervention (PCI) is well known as "restenosis". This phenomenon is due to vessel remodeling/recoil in case of no-stent strategy or, in case of stent employ, "neointimal proliferation" that consists in an excessive tissue proliferation in the luminal surface of...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2016.10.93
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Hand sewn cervical esophagogastric anastomosis (CEGA) is regarded as preferred technique by surgeons after esophagectomy. However, considering the anastomotic leakage and stricture, the optimal technique for performing this anastomosis is still under debate. METHODS:Between November 2010 and September 2012,...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2015.11.09
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:According to the present evidences suggesting association between low testosterone level and prediction of reduced exercise capacity as well as poor clinical outcome in patients with heart failure, we sought to determine if testosterone replacement therapy (TRT) improves clinical and cardiovascular condition...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2016.03.39
更新日期:2016-05-01 00:00:00
abstract:Background:Uniportal video-assisted thoracoscopic (U-VATS) lobectomy has been becoming the technique of choice in an increasing number of centers. The aim of our study was to review our experience, evaluating the learning curve of U-VATS for lung lobectomy and outcomes. Methods:The prospectively collected clinical dat...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.03.133
更新日期:2018-11-01 00:00:00
abstract::Protocols for the management of air leaks are critical aspects in the postoperative course of patients following lung resections. Many investigations in the last decade are focusing on the chest tube modalities or preventative measures, however, little is known about the pathophysiology of air leak and the patient per...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.3978/j.issn.2072-1439.2015.11.08
更新日期:2016-02-01 00:00:00
abstract:Background:There is a lack of data regarding the incidence and associated factors of pneumothorax following thoracentesis conducted in emergency department (ED) settings. The present study aims to determine the incidence of pneumothorax following thoracentesis in ED settings and evaluate the association of specific dem...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2017.08.127
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Recent evidence suggests that a histone deacetylase inhibitor, suberoylanilide hydroxamic acid (SAHA), has anti-fibrotic effect. However, the exact mechanism of its anti-fibrotic potential remains is unclear. In this study, we investigated the molecular mechanism of SAHA in attenuating pulmonary fibrosis by ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.08.08
更新日期:2016-09-01 00:00:00
abstract::Fatal hemoptysis is a serious complication of pulmonary tuberculosis, which can rarely be due to a bronchial aneurysm. Here, we present a case of fatal hemoptysis due to bronchial aneurysm occurred in a 59-year-old patient of Han ethnicity suffering from active pulmonary tuberculosis. Meanwhile, we perform a literatur...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2014.04.07
更新日期:2014-06-01 00:00:00
abstract:Background:Many studies on fine-needle aspiration biopsy (FNAB) for undetermined pulmonary nodules reported that diagnostic accuracy tended to decline, whereas complication prevalence raised as the size of nodule decreased. Reconsideration on the effectiveness of FNAB would be appropriate considering the dramatic incre...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.02.58
更新日期:2019-03-01 00:00:00
abstract:Background:Vitamin C has shown several beneficial effects on sepsis in preclinical studies. However, clinical data supporting these reports are scarce. This study aimed to evaluate whether adjunctive intravenous vitamin C therapy could reduce hospital mortality in patients with severe sepsis or septic shock requiring m...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.03.03
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Intensity modulated radiotherapy (IMRT) is routinely utilized in the treatment of locally advanced non-small cell lung cancer (NSCLC). RTOG 0617 found that overall survival was impacted by increased low (5 Gy) and intermediate (30 Gy) cardiac doses. We evaluated the impact of esophageal-sparing IMRT on cardi...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.03.64
更新日期:2016-05-01 00:00:00
abstract::Obstructive sleep apnoea (OSA) is a global health problem of increasing prevalence. Effective treatments are available with continuous positive airway pressure (CPAP) therapy and mandibular advancement devices (MAD). However, there is limited long-term adherence to therapy, as CPAP and MAD require permanent usage to a...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.05.04
更新日期:2019-05-01 00:00:00
abstract:Background:Monitoring of trends in the use of the intensive care unit (ICU) and the outcomes of ICU patients is essential for the assessment of the effective use of ICU. This study aims to investigate the incidence and outcome of critical care admissions in Taiwan from 1997 to 2013. Methods:Patients >18 years who had ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.07.131
更新日期:2018-08-01 00:00:00
abstract:Background:It is urgent to explore an effective potential therapeutic strategy for ESCC. In recent years, cell-based cancer immunotherapy has become a potentially close for carcinoma therapy. Chimeric antigen receptor (CAR) T cell technology is a kind of adoptive cell therapy technique which has been developed rapidly....
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.04.91
更新日期:2018-05-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) primarily affects the lungs but due to the accompanying chronic systematic inflammation and the symptoms associated with the disease there are many extrapulmonary effects which include complex physical and metabolic adaptations. These changes have been associated with reduc...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2019.10.41
更新日期:2019-10-01 00:00:00
abstract::Preoperative patient optimisation is a key point of enhanced recovery after thoracic surgery pathways. This could be particularly advantageous when considering video-assisted thoracic surgery (VATS) lobectomy, because reduced trauma related to minimally invasive techniques is one of the main factors favouring improved...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.12.82
更新日期:2018-03-01 00:00:00
abstract::The vascular structure related compression of esophagus is rather rare. Aberrant right subclavicular artery accounts for the majority of the rare entity, while the thoracic aorta aneurysm is a more dangerous type, called as dysphagia aortica. Delay in diagnosis and treatment of the dysphagia aortica predisposes to rup...
journal_title:Journal of thoracic disease
pub_type:
doi:10.3978/j.issn.2072-1439.2013.11.15
更新日期:2013-12-01 00:00:00
abstract:Background:CirRNA Circ_0058063 has been proven as an oncogene in bladder cancer, while its involvement in esophageal squamous-cell carcinomas (ESCC) is unknown. This study aimed to investigate the role of Circ_0058063 in ESCC. Methods:Paired ESCC and non-tumor tissues were collected from ESCC patients and gene express...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.12.57
更新日期:2020-03-01 00:00:00
abstract::The purpose of this article is to provide an overview of the epidemiology of COPD in India which is one of the most affected countries in the world and contributes significantly to the mortality and morbidity of this disease; to provide insights into the etiological determinants of COPD in India; comment on treatment ...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2012.03.15
更新日期:2012-06-01 00:00:00
abstract:Background:Endoscopic thoracic sympathectomy (ETS) has been considered as a definitive treatment for hyperhidrosis. However, despite its well-established success rate, surgical treatment for craniofacial hyperhidrosis (CFH) is rarely performed due to the possibility of fatal complications and compensatory sweating. The...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2018.05.190
更新日期:2018-06-01 00:00:00
abstract::Bioresorbable vascular scaffolds (BVS) represent a disruptive technology that has caused a new revolution in interventional cardiology. BVS appear to be particularly appealing in patients presenting with an acute myocardial infarction (MI). The available evidence on the value of BVS implantation in this challenging sc...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.03.75
更新日期:2016-06-01 00:00:00
abstract:Background:The detection rate of ground-glass opacity (GGO) in young patients has increased year by year with the increasingly widespread use of high-resolution computed tomography (HRCT) and the increased resolution of HRCT imaging. However, no scholars have reported the clinical characteristics and prognosis of GGO i...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.01.32
更新日期:2019-02-01 00:00:00
abstract::Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree. The exact pathogenesis is unclear, and it has a heterogenous clinical course. Its diagnosis requires the clinician to have a high index of suspicion based on clinical symptoms and radiological features. Computed tomogra...
journal_title:Journal of thoracic disease
pub_type: 杂志文章,评审
doi:10.21037/jtd.2017.01.49
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Several studies have demonstrated that reduced lung function is a significant risk factor for lung cancer and increased surgical risk in patients with operable stages of lung cancer. The aim of the study was to perform pulmonary function tests and investigate which is a favorable respiratory function test fo...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.3978/j.issn.2072-1439.2012.08.18
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Lung ultrasound (LUS) is a clinical imaging technique for diagnosing acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In humans and several large animals, LUS demonstrates similar specificity and sensitivity to computerized tomography (CT) scanning. Current study evaluated the degree o...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2016.05.15
更新日期:2016-07-01 00:00:00
abstract::Esophageal chondromatous hamartomas are very rare tumors, characterized by proliferating hyaline cartilage cells. We described the case of a 64-year-old woman, with a progressive foreign body sensation in the laryngopharynx caused by an intraluminal pedicled mass. Transcervical esophagectomy was performed and intraope...
journal_title:Journal of thoracic disease
pub_type:
doi:10.21037/jtd.2017.02.79
更新日期:2017-03-01 00:00:00
abstract:Background:The incidence of conduction disturbances requiring permanent pacemaker (PPM) implantation following transcatheter aortic valve replacement (TAVR) have remained a common concern. The purpose of this study was to evaluate the impact of postprocedural PPM implantation following TAVR on clinical outcomes. Metho...
journal_title:Journal of thoracic disease
pub_type: 杂志文章
doi:10.21037/jtd.2019.12.02
更新日期:2019-12-01 00:00:00