Prediction of Histopathologic Growth Patterns of Colorectal Liver Metastases with a Noninvasive Imaging Method

Cheng, Jin; Wei, Jingwei; Tong, Tong; Sheng, Weiqi; Zhang, Yinli; Han, Yujia; Gu, Dongsheng; Hong, Nan; Ye, Yingjiang; Tian, Jie; Wang, Yi

doi:10.1245/s10434-019-07910-x

Cited by 53 publications

(55 citation statements)

References 27 publications

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“…Most papers ( n = 28) described retrospective analyses, while four reported planned secondary analyses of prospectively acquired data [ 32 , 33 , 34 , 35 ]. Nineteen authors analyzed computed tomography (CT) [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ], eight magnetic resonance imaging (MRI) [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ], three positron-emission tomography (PET)/CT [ 59 , 60 , 61 ], and two multiple imaging modalities (CT and MRI; PET and MRI, respectively) [ 62 , 63 ]. Various software applications were used for texture analysis, with these being custom-made in a large proportion of cases ( n = 10).…”

Section: Resultsmentioning

confidence: 99%

“…The average radiomic quality score (RQS) [ 64 ] was in the 10 ± 6.5 (range 1–22), roughly 25% of the maximum score ( n = 36). Only four studies (16%) [ 33 , 34 , 39 , 40 ] had a score higher than 18 (>50% of the maximum score). The main limitations in quality were the following: no cost-effectiveness analysis (32 studies, 100%); lack of open-data repositories ( n = 31, 97%); no phantom calibration ( n = 31, 97%); failure to include a calibration statistic ( n = 30, 94%); lack of prospective design ( n = 28, 87%); and missing validation cohort ( n = 18, 56%).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies evaluated the association between radiomic features and pathology data [ 39 , 43 , 45 ]. Lubner et al, demonstrated that entropy, mean of positive pixels, and standard deviation are inversely associated with tumor grading ( p = 0.007 for entropy, p = 0.002 for mean positive pixels, and p = 0.004 for standard deviation), while skewness and kurtosis showed a trend for an inverse association with KRAS mutation ( p = 0.04 for skewness, and p = 0.058 for kurtosis) [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…Lubner et al, demonstrated that entropy, mean of positive pixels, and standard deviation are inversely associated with tumor grading ( p = 0.007 for entropy, p = 0.002 for mean positive pixels, and p = 0.004 for standard deviation), while skewness and kurtosis showed a trend for an inverse association with KRAS mutation ( p = 0.04 for skewness, and p = 0.058 for kurtosis) [ 43 ]. Cheng et al, reported that growth patterns of LM (desmoplastic, replacing, and pushing) can be successfully discerned on CT images by using second-order radiomic features, in particular gray level size zone matrix and gray level non-uniformity (AUC = 0.926, 95%CI = 0.875–0.978 in the training dataset; AUC = 0.939, 95%CI = 0.859–1.000 in the external validation dataset) [ 39 ]. In Rao et al’s paper, the delta in entropy and uniformity values between pre- and post-chemotherapy imaging modalities were predictors of TRG values in patients receiving oxaliplatin-based chemotherapy with or without bevacizumab (entropy variation: −5.13 in TRG 1–2 vs. +1.27 in TRG 3–5, OR = 1.34, CI95% = 0.92–1.93; uniformity variation: +30.84 vs. −0.44, respectively, OR = 0.95, CI95% = 0.89–1.01), while RECIST criteria were not [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…Radiomic features not only demonstrated an earlier evaluation of response than standard RECIST criteria [ 33 ], but also an adequate assessment of TRG [ 45 ]. Texture analyses were also able to predict additional pathology details of LM that have a prognostic impact, such as tumor growth patterns [ 39 ]. Those data can allow a real precision medicine, planning treatment based on a reliable evaluation of the effectiveness of therapies and prognosis, that, to date, can be assessed only ex-post.…”

Section: Discussionmentioning

confidence: 99%

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Radiomics of Liver Metastases: A Systematic Review

Fiz

Viganò

Gennaro

et al. 2020

Cancers

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Multidisciplinary management of patients with liver metastases (LM) requires a precision medicine approach, based on adequate profiling of tumor biology and robust biomarkers. Radiomics, defined as the high-throughput identification, analysis, and translational applications of radiological textural features, could fulfill this need. The present review aims to elucidate the contribution of radiomic analyses to the management of patients with LM. We performed a systematic review of the literature through the most relevant databases and web sources. English language original articles published before June 2020 and concerning radiomics of LM extracted from CT, MRI, or PET-CT were considered. Thirty-two papers were identified. Baseline higher entropy and lower homogeneity of LM were associated with better survival and higher chemotherapy response rates. A decrease in entropy and an increase in homogeneity after chemotherapy correlated with radiological tumor response. Entropy and homogeneity were also highly predictive of tumor regression grade. In comparison with RECIST criteria, radiomic features provided an earlier prediction of response to chemotherapy. Lastly, texture analyses could differentiate LM from other liver tumors. The commonest limitations of studies were small sample size, retrospective design, lack of validation datasets, and unavailability of univocal cut-off values of radiomic features. In conclusion, radiomics can potentially contribute to the precision medicine approach to patients with LM, but interdisciplinarity, standardization, and adequate software tools are needed to translate the anticipated potentialities into clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Radiomics of Liver Metastases: A Systematic Review

Fiz

Viganò

Gennaro

et al. 2020

Cancers

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Replacement and desmoplastic histopathological growth patterns in cutaneous melanoma liver metastases: frequency, characteristics, and robust prognostic value

Barnhill

Dam

Vermeulen

et al. 2020

The Journal of Pathology CR

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Among visceral metastatic sites, cutaneous melanoma (CM) metastasises initially to the liver in ~14–20% of cases. Liver metastases in CM patients are associated with both poor prognosis and poor response to immunotherapy. Histopathological growth patterns (HGPs) of liver metastases of the replacement and desmoplastic type, particularly from colorectal cancer and uveal melanoma (UM), may impart valuable biological and prognostic information. Here, we have studied HGP in 43 CM liver metastases resected from 42 CM patients along with other prognostic factors from three institutions. The HGPs (replacement, desmoplastic, pushing) were scored at the metastasis–liver interface with two algorithms: (1) 100% desmoplastic growth pattern (dHGP) and any (≥1%) replacement pattern (any‐rHGP) and (2) >50% dHGP, >50% rHGP or mixed (<50% dHGP and/or rHGP, pushing HGP). For 1 patient with 2 metastases, an average was taken to obtain 1 final HGP yielding 42 observations from 42 patients. 22 cases (52%) had 100% dHGP whereas 20 (48%) had any replacement. Cases with rHGP demonstrated vascular co‐option/angiotropism. With the development of liver metastasis, only rHGP (both algorithms), male gender and positive resection margins predicted diminished overall survival ( p = 0.00099 and p = 0.0015; p = 0.034 and p = 0.024 respectively). On multivariate analysis, only HGP remained significant. 7 of 42 (17%) patients were alive with disease and 21 (50%) died with follow‐up after liver metastases ranging from 1.8 to 42.2 months (mean: 20.4 months, median: 19.0 months). 14 (33%) patients with previously‐treated metastatic disease had no evidence of disease at last follow up. In conclusion, we report for the first time replacement and desmoplastic HGPs in CM liver metastases and their prognostic value, as in UM and other solid cancers. Of particular importance, any rHGP significantly predicted diminished overall survival while 100% dHGP correlated with increased survival. These results contribute to a better understanding of the biology of CM liver metastases and potentially may be utilised in managing patients with these metastases.

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Preoperative systemic chemotherapy alters the histopathological growth patterns of colorectal liver metastases

Nierop

Höppener

Buisman

et al. 2021

The Journal of Pathology CR

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Histopathological growth patterns (HGPs) are a reliable, reproducible, and strong prognostic biomarker that can be assessed on haematoxylin and eosin-stained sections of resected colorectal liver metastases (CRLM). Assessment estimates the relative fraction of the tumour-liver interface for each of the three growth patterns; the desmoplastic HGP reflects good prognosis. Whether preoperative chemotherapy affects the HGP is currently unclear. The present international multicentre study evaluates this in an original cohort of 877 consecutive patients treated in the Netherlands, an external validation cohort of 1,203 consecutive patients treated in the USA, and a post hoc analysis from the phase III randomised controlled European Organization for Research and Treatment of Cancer (EORTC) 40983 trial (n = 70). All patients underwent resection of CRLM with or without preoperative systemic chemotherapy. Trial patients were randomised between perioperative chemotherapy and resection or resection alone. HGPs were determined according to consensus guidelines and compared for preoperative treatment status. Data from three separate tumour regression grading systems were available for the trial cohort. These were correlated with HGP stratified for treatment arm. In the original cohort, the average presence of desmoplastic HGP was 43% for chemo-naïve versus 67% for preoperatively treated patients (p < 0.001). A significant association between chemotherapy and desmoplastic HGP was found on multivariable analysis (β [95% confidence interval, CI]: 24.57 [18.28-30.87], p < 0.001). In the validation cohort, the average presence of desmoplastic HGP was 40% for chemo-naïve versus 63% for preoperatively treated patients (p < 0.001). This association remained on multivariable analysis (β [95% CI]: 24.18 [18.70-29.66], p < 0.001). In the EORTC 40983 trial, the average desmoplastic HGP presence was 33% in the resection arm versus 61% in the chemotherapy arm (p = 0.005). Chemotherapy was independently associated with an increase in desmoplastic HGP (β [95% CI]: 23.29 [1.78-44.79], p = 0.022). All three tumour regression gradings were significantly associated with the desmoplastic HGP in the chemotherapy arm (all p < 0.04). None were associated in the resection arm (all p > 0.11). Preoperative chemotherapy induces histopathological changes that alter the HGP of CRLM.

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Prediction of Histopathologic Growth Patterns of Colorectal Liver Metastases with a Noninvasive Imaging Method

Cited by 53 publications

References 27 publications

Radiomics of Liver Metastases: A Systematic Review

Radiomics of Liver Metastases: A Systematic Review

Replacement and desmoplastic histopathological growth patterns in cutaneous melanoma liver metastases: frequency, characteristics, and robust prognostic value

Preoperative systemic chemotherapy alters the histopathological growth patterns of colorectal liver metastases

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