Radiogenomics of High-Grade Serous Ovarian Cancer: Multireader Multi-Institutional Study from the Cancer Genome Atlas Ovarian Cancer Imaging Research Group

Abstract

Purpose To evaluate interradiologist agreement on assessments of computed tomography (CT) imaging features of high-grade serous ovarian cancer (HGSOC), to assess their associations with time-to-disease progression (TTP) and HGSOC transcriptomic profiles (Classification of Ovarian Cancer [CLOVAR]), and to develop an imaging-based risk score system to predict TTP and CLOVAR profiles. Materials and Methods This study was a multireader, multi-institutional, institutional review board-approved, HIPAA-compliant retrospective analysis of 92 patients with HGSOC (median age, 61 years) with abdominopelvic CT before primary cytoreductive surgery available through the Cancer Imaging Archive. Eight radiologists from the Cancer Genome Atlas Ovarian Cancer Imaging Research Group developed and independently recorded the following CT features: characteristics of primary ovarian mass(es), presence of definable mesenteric implants and infiltration, presence of other implants, presence and distribution of peritoneal spread, presence and size of pleural effusions and ascites, lymphadenopathy, and distant metastases. Interobserver agreement for CT features was assessed, as were univariate and multivariate associations with TTP and CLOVAR mesenchymal profile (worst prognosis). Results Interobserver agreement for some features was strong (eg, α = .78 for pleural effusion and ascites) but was lower for others (eg, α = .08 for intraparenchymal splenic metastases). Presence of peritoneal disease in the right upper quadrant (P = .0003), supradiaphragmatic lymphadenopathy (P = .0004), more peritoneal disease sites (P = .0006), and nonvisualization of a discrete ovarian mass (P = .0037) were associated with shorter TTP. More peritoneal disease sites (P = .0025) and presence of pouch of Douglas implants (P = .0045) were associated with CLOVAR mesenchymal profile. Combinations of imaging features contained predictive signal for TTP (concordance index = 0.658; P = .0006) and CLOVAR profile (mean squared deviation = 1.776; P = .0043). Conclusion These results provide some evidence of the clinical and biologic validity of these image features. Interobserver agreement is strong for some features, but could be improved for others. RSNA, 2017 Online supplemental material is available for this article.

Integration of proteomics with CT-based qualitative and radiomic features in high-grade serous ovarian cancer patients: an exploratory analysis

“…This was a multi-institutional, institutional review board-approved, and Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study, with waiver of informed consent from all institutions that participated in The Cancer Genome Atlas-Ovarian Cancer (TCGA-OV) Imaging Research Group [21].…”

Computed Tomography Measures of Inter-site tumor Heterogeneity for Classifying Outcomes in High-Grade Serous Ovarian Carcinoma: a Retrospective Study

“…28 The ability to predict patients with poor outcomes using non-invasive imaging-based 29 methods that quantify heterogeneity within (intra-site) and between separate tumor sites 30 (inter-site) would have high clinical utility. Therefore the aims of this retrospective study 31 were: (1) to develop computational texture analyses methods from standard of care CT 32 images that incorporate both intra-site and inter-site spatial heterogeneity and (2) All patients from the current study were included in two prior studies that investigated 59 the associations between qualitative CT imaging features, Classification of Ovarian Cancer 60 (CLOVAR) transcriptomic profiles and survival in a single and multiple institution datasets, 61 respectively [25,26]. Previously [27], we also evaluated the feasibility of CT-based texture 62 measures of inter-site tumor heterogeneity in 38 patients from the MSKCC dataset.…”

Background, current role, and potential applications of radiogenomics

“…Following this study, a multiinstitutional study of 92 patients with high‐grade serous ovarian cancer was performed in order to generate risk scores based on combinations of CT imaging features that can predict either time‐to‐disease (TTP) or CLOVAR profile. Multiple preoperative CT imaging features were significantly associated with TTP progression and CLOVAR genomic subtypes . The presence of peritoneal disease in the right upper quadrant, supradiaphragmatic lympoadenopathy, more peritoneal disease sites, and nonvisualization of a discrete ovarian mass were determined to be associated with a shorter TTP progression.…”

“…Multiple preoperative CT imaging features were significantly associated with TTP progression and CLOVAR genomic subtypes. 84 The presence of peritoneal disease in the right upper quadrant, supradiaphragmatic lympoadenopathy, more peritoneal disease sites, and nonvisualization of a discrete ovarian mass were determined to be associated with a shorter TTP progression. More peritoneal disease sites (also associated with a shorter TTP progression) and presence of pouch of Douglas implants were determined to be associated with the CLO-VAR mesenchymal subtype, which indicates a worst prognosis.…”