CT radiomics associations with genotype and stromal content in pancreatic ductal adenocarcinoma

Attiyeh, Marc A.; Chakraborty, Jayasree; McIntyre, Caitlin A.; Kappagantula, Rajya; Chou, Yu-Ting; Aşkan, Gökçe; Seier, Kenneth; Gönen, Mithat; Baştürk, Olca; Balachandran, Vinod P.; Kingham, T. Peter; D’Angelica, Michael I.; Drebin, Jeffrey A.; Jarnagin, William R.; Allen, Peter J.; Iacobuzio‐Donahue, Christine A.; Simpson, Amber L.; Richard, K. G.

doi:10.1007/s00261-019-02112-1

Cited by 41 publications

(30 citation statements)

References 33 publications

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“…Contrast-enhanced CT was used in PDAC detection, staging, and evaluation of prognosis. A previous study also found that CT radiomics could predict PDAC SMAD4 status and tumor stromal content (Attiyeh et al, 2019). X-ray radiation and iodine allergy are the major risks of CT. Endoscopic ultrasonography (EUS) is the most sensitive non-operative imaging method for the detection of pancreatic cancer and showed to be superior to CT (Luz et al, 2014;Singh and Faulx, 2016).…”

Section: Introductionmentioning

confidence: 86%

Multiparametric Mapping Magnetic Resonance Imaging of Pancreatic Disease

et al. 2020

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Background: Current magnetic resonance imaging (MRI) of pancreatic disease is qualitative in nature. Quantitative imaging offers several advantages, including increased reproducibility and sensitivity to detect mild or diffuse disease. The role of multiparametric mapping MRI in characterizing various tissue types in pancreatic disease such as chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) has rarely been evaluated. Purpose: To evaluate the feasibility of multiparametric mapping [T1, T2, and apparent diffusion coefficient (ADC)] in defining tissue characteristics that occur in CP and PDAC to improve disease diagnosis. Materials and Methods: Pancreatic MRI was performed in 17 patients with PDAC undergoing therapy, 7 patients with CP, and 29 healthy volunteers with no pancreatic disease. T1 modified Look-Locker Inversion Recovery (T1 MOLLI), T2-prepared gradient-echo, and multi-slice single-shot echo-planar diffusion weighted imaging (SS-EPI DWI) sequences were used for data acquisition. Regions of interest (ROIs) of pancreas in PDAC, CP, and control subjects were outlined by an experienced radiologist. One-way analysis of variance (ANOVA) was used to compare the difference between groups and regions of the pancreas, and Tukey tests were used for multiple comparison testing within groups. Receiver operator characteristic (ROC) curves were analyzed, and the areas under the curves (AUCs) were calculated using single parameter and combined parameters, respectively. Results: T1, T2, and ADC values of the entire pancreas among PDAC, CP, and control subjects; and between upstream and downstream portions of the pancreas in PDAC patients were all significantly different (p < 0.05). The AUC values were 0.90 for T1, 0.55 for T2, and 0.71 for ADC for independent prediction of PDAC. By combining T1, T2, and ADC, the AUC value was 0.94 (sensitivity 91.54%, specificity 85.81%, 95% CI: 0.92-0.96), which yielded higher accuracy than any one parameter only (p < 0.001).

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Section: Introductionmentioning

confidence: 86%

Multiparametric Mapping Magnetic Resonance Imaging of Pancreatic Disease

et al. 2020

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“…Additionally, Torphy et al analyzed the standard multiphase CT images of the whole tumor and indicated the correlation of high stromal component with favorable outcome in resected cases ( 15 ). By evaluating all tumor slides for the stromal proportion, Attiyeh et al found that tumors with ≤ 50% stroma ( n = 21) harbored significantly more altered genes than those with >50% stroma ( n = 14) ( 16 ). Therefore, evaluating the stromal component for the whole tumor may clearly clarify the effect of stromal component on the prognosis of patients with PDAC.…”

Section: Introductionmentioning

confidence: 99%

Pros and Cons: High Proportion of Stromal Component Indicates Better Prognosis in Patients With Pancreatic Ductal Adenocarcinoma—A Research Based on the Evaluation of Whole-Mount Histological Slides

Wang

Jiang

et al. 2020

Front. Oncol.

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The study aimed to investigate the potential of tumor–stroma ratio (TSR) on digitalized whole-mount histopathology to predict prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). The effectiveness were evaluated through internal validation. Data were retrospectively collected from consecutive patients who underwent primary pancreatic resection from December 2016 to August 2017 (developing cohort) and from September 2017 to April 2018 (validation cohort). Digitalized whole-mount slide images were used to evaluate TSR by both pathologists and a computerized model based on Conditional Generative Adversarial Model (cGAN), respectively. TSR>1 and ≤ 1 denoted low and high stromal component. Logistic regression analysis revealed intratumoral necrosis and R1 independently associated with low stromal component in the developing cohort. Cox regression analysis revealed tumor–node–metastasis (TNM) stage [II vs. I: hazard ratio (HR), 2.584; 95% CI, 1.386–4.819; P = 0.003; III vs. I: HR, 4.384; 95% CI, 2.285–8.411; P < 0.001], stromal component (low vs. high: HR, 1.876; 95% CI, 1.227–2.870; P = 0.004), tumor grade (G3 vs. G1/2: HR, 2.124; 95% CI, 1.419–3.179; P < 0.001), and perineural invasion (with vs. without: HR, 2.147; 95% CI, 1.187–3.883; P = 0.011) were independent prognostic factors in the developing cohort. Stromal component categories could classify patients into subgroups within TNM stages I, II, and III based on over survival. All results were validated in the validation cohort. The weighted kappa value for categorical assessments between pathologists' evaluation and computer-aided evaluation was 0.804 (95% CI, 0.573–0.951). TSR represents a simple and reliable metric for combining the prognostic value of TNM stage in patients with PDAC.

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“…Several studies have explored the correlation between imaging features and TP53 mutation in some kinds of cancers, including LUAD (33), pancreatic ductal adenocarcinoma (34,35), head and neck cancer (36), colorectal cancer (37), glioma (38). In the study conducted by Wang et al (33), they enrolled 51 patients with resectable early stage LUAD.…”

Section: Discussionmentioning

confidence: 99%

A computed tomography (CT)-derived radiomics approach for predicting primary co-mutations involving TP53 and epidermal growth factor receptor (EGFR) in patients with advanced lung adenocarcinomas (LUAD)

Zhu¹,

Guo²,

Xu³

et al. 2021

Ann Transl Med

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Background: Epidermal growth factor receptor (EGFR) co-mutated with TP53 could reduce responsiveness to tyrosine kinase inhibitors (TKIs) and worsen patients' prognosis compared to TP53 wild type patients in EGFR-mutated lung adenocarcinomas (LUAD). To identify this genetically unique subset prior to treatment through computed tomography (CT) images had not been reported yet.Methods: Stage III and IV LUAD with known mutation status of EGFR and TP53 from The First Affiliated Hospital of Sun Yat-sen University (May 1, 2017 to June 1, 2020) were collected. Characteristics of pretreatment enhanced-CT images were analyzed. One-versus-one was used as the multiclass classification strategy to distinguish the three subtypes of co-mutations:clinical model, semantic model, radiomics model and integrated model were built. Area under the receiveroperating characteristic curves (AUCs) were used to evaluate the prediction efficacy.Results: A total of 199 patients were enrolled, including 83 (42%) cases of EGFR − , 55 (28%) cases of EGFR + & TP53 + , 61 (31%) cases of EGFR + & TP53 − . Among the four different models, the integrated model displayed the best performance for all the three subtypes of co-mutations:

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CT radiomics associations with genotype and stromal content in pancreatic ductal adenocarcinoma

Cited by 41 publications

References 33 publications

Multiparametric Mapping Magnetic Resonance Imaging of Pancreatic Disease

Multiparametric Mapping Magnetic Resonance Imaging of Pancreatic Disease

Pros and Cons: High Proportion of Stromal Component Indicates Better Prognosis in Patients With Pancreatic Ductal Adenocarcinoma—A Research Based on the Evaluation of Whole-Mount Histological Slides

A computed tomography (CT)-derived radiomics approach for predicting primary co-mutations involving TP53 and epidermal growth factor receptor (EGFR) in patients with advanced lung adenocarcinomas (LUAD)

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