Defining a Radiomic Response Phenotype: A Pilot Study using targeted therapy in NSCLC

Sci Rep. 2016 Sep 20:6:33860. doi: 10.1038/srep33860.

Abstract

Medical imaging plays a fundamental role in oncology and drug development, by providing a non-invasive method to visualize tumor phenotype. Radiomics can quantify this phenotype comprehensively by applying image-characterization algorithms, and may provide important information beyond tumor size or burden. In this study, we investigated if radiomics can identify a gefitinib response-phenotype, studying high-resolution computed-tomography (CT) imaging of forty-seven patients with early-stage non-small cell lung cancer before and after three weeks of therapy. On the baseline-scan, radiomic-feature Laws-Energy was significantly predictive for EGFR-mutation status (AUC = 0.67, p = 0.03), while volume (AUC = 0.59, p = 0.27) and diameter (AUC = 0.56, p = 0.46) were not. Although no features were predictive on the post-treatment scan (p > 0.08), the change in features between the two scans was strongly predictive (significant feature AUC-range = 0.74-0.91). A technical validation revealed that the associated features were also highly stable for test-retest (mean ± std: ICC = 0.96 ± 0.06). This pilot study shows that radiomic data before treatment is able to predict mutation status and associated gefitinib response non-invasively, demonstrating the potential of radiomics-based phenotyping to improve the stratification and response assessment between tyrosine kinase inhibitors (TKIs) sensitive and resistant patient populations.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Carcinoma, Non-Small-Cell Lung* / therapy
  • ErbB Receptors*
  • Female
  • Follow-Up Studies
  • Gefitinib
  • Humans
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / therapy
  • Male
  • Mutation*
  • Neoadjuvant Therapy*
  • Pilot Projects
  • Quinazolines / administration & dosage*
  • Tomography, X-Ray Computed*

Substances

  • Quinazolines
  • EGFR protein, human
  • ErbB Receptors
  • Gefitinib