Intratumoral and peritumoral CT radiomics in predicting anaplastic lymphoma kinase mutations and survival in patients with lung adenocarcinoma: a multicenter study.
Weiyue Chen, Guihan Lin, Ye Feng, Yongjun Chen, Yanjun Li, Jianbin Li, Weibo Mao, Yang Jing, Chunli Kong, Yumin Hu, Minjiang Chen, Shuiwei Xia, Chenying Lu, Jianfei Tu, Jiansong Ji
{"title":"Intratumoral and peritumoral CT radiomics in predicting anaplastic lymphoma kinase mutations and survival in patients with lung adenocarcinoma: a multicenter study.","authors":"Weiyue Chen, Guihan Lin, Ye Feng, Yongjun Chen, Yanjun Li, Jianbin Li, Weibo Mao, Yang Jing, Chunli Kong, Yumin Hu, Minjiang Chen, Shuiwei Xia, Chenying Lu, Jianfei Tu, Jiansong Ji","doi":"10.1186/s40644-025-00856-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To explore the value of intratumoral and peritumoral radiomics in preoperative prediction of anaplastic lymphoma kinase (ALK) mutation status and survival in patients with lung adenocarcinoma.</p><p><strong>Methods: </strong>We retrospectively collected data from 505 eligible patients with lung adenocarcinoma from four hospitals (training and external validation sets 1-3). The CT-based radiomics features were extracted separately from the gross tumor volume (GTV) and GTV incorporating peritumoral 3-, 6-, 9-, 12-, and 15-mm regions (GPTV<sub>3</sub>, GPTV<sub>6</sub>, GPTV<sub>9</sub>, GPTV<sub>12</sub>, and GPTV<sub>15</sub>), and screened the most relevant features to construct radiomics models to predict ALK (+). The combined model incorporated radiomics scores (Rad-scores) of the best radiomics model and clinical predictors was constructed. Performance was evaluated using receiver operating characteristic (ROC) analysis. Progression-free survival (PFS) outcomes were examined using the Cox proportional hazards model.</p><p><strong>Results: </strong>In the four sets, 21.19% (107/505) patients were ALK (+). The GPTV<sub>3</sub> radiomics model using a support vector machine algorithm achieved the best predictive performance, with the highest average AUC of 0.811 in the validation sets. Clinical TNM stage and pleural indentation were independent predictors. The combined model incorporating the GPTV<sub>3</sub>-Rad-score and clinical predictors achieved higher performance than the clinical model alone in predicting ALK (+) in three validation sets [AUC: 0.855 (95% CI: 0.766-0.919) vs. 0.648 (95% CI: 0.543-0.745), P = 0.001; 0.882 (95% CI: 0.801-0.962) vs. 0.634 (95% CI: 0.548-0.714), P < 0.001; 0.810 (95% CI: 0.727-0.877) vs. 0.663 (95% CI: 0.570-0.748), P = 0.006]. The prediction score of the combined model could stratify PFS outcomes in patients receiving ALK-TKI therapy (HR: 0.37; 95% CI: 0.15-0.89; P = 0.026) and immunotherapy (HR: 2.49; 95% CI: 1.22-5.08; P = 0.012).</p><p><strong>Conclusion: </strong>The presented combined model based on GPTV<sub>3</sub> effectively mined tumor features to predict ALK mutation status and stratify PFS outcomes in patients with lung adenocarcinoma.</p>","PeriodicalId":9548,"journal":{"name":"Cancer Imaging","volume":"25 1","pages":"35"},"PeriodicalIF":3.5000,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907895/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40644-025-00856-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: To explore the value of intratumoral and peritumoral radiomics in preoperative prediction of anaplastic lymphoma kinase (ALK) mutation status and survival in patients with lung adenocarcinoma.
Methods: We retrospectively collected data from 505 eligible patients with lung adenocarcinoma from four hospitals (training and external validation sets 1-3). The CT-based radiomics features were extracted separately from the gross tumor volume (GTV) and GTV incorporating peritumoral 3-, 6-, 9-, 12-, and 15-mm regions (GPTV3, GPTV6, GPTV9, GPTV12, and GPTV15), and screened the most relevant features to construct radiomics models to predict ALK (+). The combined model incorporated radiomics scores (Rad-scores) of the best radiomics model and clinical predictors was constructed. Performance was evaluated using receiver operating characteristic (ROC) analysis. Progression-free survival (PFS) outcomes were examined using the Cox proportional hazards model.
Results: In the four sets, 21.19% (107/505) patients were ALK (+). The GPTV3 radiomics model using a support vector machine algorithm achieved the best predictive performance, with the highest average AUC of 0.811 in the validation sets. Clinical TNM stage and pleural indentation were independent predictors. The combined model incorporating the GPTV3-Rad-score and clinical predictors achieved higher performance than the clinical model alone in predicting ALK (+) in three validation sets [AUC: 0.855 (95% CI: 0.766-0.919) vs. 0.648 (95% CI: 0.543-0.745), P = 0.001; 0.882 (95% CI: 0.801-0.962) vs. 0.634 (95% CI: 0.548-0.714), P < 0.001; 0.810 (95% CI: 0.727-0.877) vs. 0.663 (95% CI: 0.570-0.748), P = 0.006]. The prediction score of the combined model could stratify PFS outcomes in patients receiving ALK-TKI therapy (HR: 0.37; 95% CI: 0.15-0.89; P = 0.026) and immunotherapy (HR: 2.49; 95% CI: 1.22-5.08; P = 0.012).
Conclusion: The presented combined model based on GPTV3 effectively mined tumor features to predict ALK mutation status and stratify PFS outcomes in patients with lung adenocarcinoma.
Cancer ImagingONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
7.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍:
Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology.
The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include:
Breast Imaging
Chest
Complications of treatment
Ear, Nose & Throat
Gastrointestinal
Hepatobiliary & Pancreatic
Imaging biomarkers
Interventional
Lymphoma
Measurement of tumour response
Molecular functional imaging
Musculoskeletal
Neuro oncology
Nuclear Medicine
Paediatric.