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07.08.2017 | Computed Tomography

Prognostic value and molecular correlates of a CT image-based quantitative pleural contact index in early stage NSCLC

verfasst von: Juheon Lee, Yi Cui, Xiaoli Sun, Bailiang Li, Jia Wu, Dengwang Li, Michael F Gensheimer, Billy W Loo Jr., Maximilian Diehn, Ruijiang Li

Erschienen in: European Radiology | Ausgabe 2/2018

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Abstract

Purpose

To evaluate the prognostic value and molecular basis of a CT-derived pleural contact index (PCI) in early stage non-small cell lung cancer (NSCLC).

Experimental design

We retrospectively analysed seven NSCLC cohorts. A quantitative PCI was defined on CT as the length of tumour-pleura interface normalised by tumour diameter. We evaluated the prognostic value of PCI in a discovery cohort (n = 117) and tested in an external cohort (n = 88) of stage I NSCLC. Additionally, we identified the molecular correlates and built a gene expression-based surrogate of PCI using another cohort of 89 patients. To further evaluate the prognostic relevance, we used four datasets totalling 775 stage I patients with publically available gene expression data and linked survival information.

Results

At a cutoff of 0.8, PCI stratified patients for overall survival in both imaging cohorts (log-rank p = 0.0076, 0.0304). Extracellular matrix (ECM) remodelling was enriched among genes associated with PCI (p = 0.0003). The genomic surrogate of PCI remained an independent predictor of overall survival in the gene expression cohorts (hazard ratio: 1.46, p = 0.0007) adjusting for age, gender, and tumour stage.

Conclusions

CT-derived pleural contact index is associated with ECM remodelling and may serve as a noninvasive prognostic marker in early stage NSCLC.

Key points

• A quantitative pleural contact index (PCI) predicts survival in early stage NSCLC.

• PCI is associated with extracellular matrix organisation and collagen catabolic process.

• A multi-gene surrogate of PCI is an independent predictor of survival.

• PCI can be used to noninvasively identify patients with poor prognosis.

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Titel: Prognostic value and molecular correlates of a CT image-based quantitative pleural contact index in early stage NSCLC
verfasst von: Juheon Lee
Yi Cui
Xiaoli Sun
Bailiang Li
Jia Wu
Dengwang Li
Michael F Gensheimer
Billy W Loo Jr.
Maximilian Diehn
Ruijiang Li
Publikationsdatum: 07.08.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4996-4

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Prognostic value and molecular correlates of a CT image-based quantitative pleural contact index in early stage NSCLC