Erschienen in:
17.01.2020 | Oncology
Can radiomics improve the prediction of metastatic relapse of myxoid/round cell liposarcomas?
verfasst von:
Amandine Crombé, François Le Loarer, Maxime Sitbon, Antoine Italiano, Eberhard Stoeckle, Xavier Buy, Michèle Kind
Erschienen in:
European Radiology
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Ausgabe 5/2020
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Abstract
Objective
The strongest adverse prognostic factor in myxoid/round cell liposarcomas (MRC-LPS) is the presence of a round cell component above 5% within the tumor bulk. Its identification is underestimated on biopsies and in the neoadjuvant setting. The aim was to improve the prediction of patients’ prognosis through a radiomics approach.
Methods
Thirty-five out of 89 patients with MRC-LPS managed at our sarcoma reference center from 2008 to 2017 were included in this IRB-approved retrospective study as they presented with a pre-treatment contrast-enhanced MRI (median age, 49 years old). Two radiologists reported usual conventional/semantic radiological variables. After signal intensity (SI) normalization, voxel size standardization of T2-WI, and whole tumor volume segmentation, 44 3D-radiomics features were extracted. Using least absolute shrinkage and selection operator penalized Cox regression on prefiltered features, a radiomics score based on 3 weighted radiomics features was generated. Four prognostic multivariate models for MRFS were compared using concordance index: (1) clinical model, (2) semantic radiological model, (3) radiomics model, and (4) radiomics + semantic radiological model.
Results
Twelve patients showed a metastatic relapse. The radiomics score included FOS_Skewness, GLRLM_LRHGE, and SHAPE_Volume and correlated with MRFS (hazard ratio = 19.37, p = 0.0009) and visual heterogeneity on T2-WI (p < 0.0001). A high score indicated a poorer prognosis. After adjustment, the best predictive performances were obtained with model (4) (concordance index = 0.937) and the lowest with model (1) (concordance index = 0.637).
Conclusion
Adding selected radiomics features that quantify tumor heterogeneity and shape at baseline to a conventional radiological analysis improves prediction of MRC-LPS patients’ prognosis.
Key Points
• Fourteen radiomics features quantifying shape and heterogeneity of myxoid/round cell liposarcomas on T2-WI were associated with metastatic relapse in univariate analysis.
• A radiomics score based on 3 selected and weighted radiomics features was a strong and independent prognostic factor for metastatic relapse-free survival.
• The best prediction of metastatic relapse-free survival for myxoid/round cell liposarcomas was achieved by combining the radiomics score to relevant radiological features.