The value of nodal information in predicting lung cancer relapse using 4DPET/4DCT.

Abstract:

PURPOSE:There is evidence that computed tomography (CT) and positron emission tomography (PET) imaging metrics are prognostic and predictive in nonsmall cell lung cancer (NSCLC) treatment outcomes. However, few studies have explored the use of standardized uptake value (SUV)-based image features of nodal regions as predictive features. The authors investigated and compared the use of tumor and node image features extracted from the radiotherapy target volumes to predict relapse in a cohort of NSCLC patients undergoing chemoradiation treatment. METHODS:A prospective cohort of 25 patients with locally advanced NSCLC underwent 4DPET/4DCT imaging for radiation planning. Thirty-seven image features were derived from the CT-defined volumes and SUVs of the PET image from both the tumor and nodal target regions. The machine learning methods of logistic regression and repeated stratified five-fold cross-validation (CV) were used to predict local and overall relapses in 2 yr. The authors used well-known feature selection methods (Spearman's rank correlation, recursive feature elimination) within each fold of CV. Classifiers were ranked on their Matthew's correlation coefficient (MCC) after CV. Area under the curve, sensitivity, and specificity values are also presented. RESULTS:For predicting local relapse, the best classifier found had a mean MCC of 0.07 and was composed of eight tumor features. For predicting overall relapse, the best classifier found had a mean MCC of 0.29 and was composed of a single feature: the volume greater than 0.5 times the maximum SUV (N). CONCLUSIONS:The best classifier for predicting local relapse had only tumor features. In contrast, the best classifier for predicting overall relapse included a node feature. Overall, the methods showed that nodes add value in predicting overall relapse but not local relapse.

journal_name

Med Phys

journal_title

Medical physics

authors

Li H,Becker N,Raman S,Chan TC,Bissonnette JP

doi

10.1118/1.4926755

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

4727-33

issue

8

eissn

0094-2405

issn

2473-4209

journal_volume

42

pub_type

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