Journal article
Radiomic Features Associated With HPV Status on Pretreatment Computed Tomography in Oropharyngeal Squamous Cell Carcinoma Inform Clinical Prognosis
Frontiers in oncology, Vol.11, pp.744250-744250
09/07/2021
DOI: 10.3389/fonc.2021.744250
PMCID: PMC8454409
PMID: 34557418
Abstract
Purpose
There is a lack of biomarkers for accurately prognosticating outcome in both human papillomavirus-related (HPV+) and tobacco- and alcohol-related (HPV-) oropharyngeal squamous cell carcinoma (OPSCC). The aims of this study were to i) develop and evaluate radiomic features within (intratumoral) and around tumor (peritumoral) on CT scans to predict HPV status; ii) investigate the prognostic value of the radiomic features for both HPV- and HPV+ patients, including within individual AJCC eighth edition-defined stage groups; and iii) develop and evaluate a clinicopathologic imaging nomogram involving radiomic, clinical, and pathologic factors for disease-free survival (DFS) prediction for HPV+ patients.
Experimental Design
This retrospective study included 582 OPSCC patients, of which 462 were obtained from The Cancer Imaging Archive (TCIA) with available tumor segmentation and 120 were from Cleveland Clinic Foundation (CCF, denoted as S-CCF) with HPV+ OPSCC. We subdivided the TCIA cohort into training (S-T, 180 patients) and validation (S-V, 282 patients) based on an approximately 3:5 ratio for HPV status prediction. The top 15 radiomic features that were associated with HPV status were selected by the minimum redundancy-maximum relevance (MRMR) using S-T and evaluated on S-V. Using 3 of these 15 top HPV status-associated features, we created radiomic risk scores for both HPV+ (RRSHPV+) and HPV- patients (RRSHPV-) through a Cox regression model to predict DFS. RRSHPV+ was further externally validated on S-CCF. Nomograms for the HPV+ population (Mp+RRS) were constructed. Both RRSHPV+ and Mp+RRS were used to prognosticate DFS for the AJCC eighth edition-defined stage I, stage II, and stage III patients separately.
Results
RRSHPV+ was prognostic for DFS for i) the whole HPV+ population [hazard ratio (HR) = 1.97, 95% confidence interval (CI): 1.35-2.88, p < 0.001], ii) the AJCC eighth stage I population (HR = 1.99, 95% CI: 1.04-3.83, p = 0.039), and iii) the AJCC eighth stage II population (HR = 3.61, 95% CI: 1.71-7.62, p < 0.001). HPV+ nomogram Mp+RRS (C-index, 0.59; 95% CI: 0.54-0.65) was also prognostic of DFS (HR = 1.86, 95% CI: 1.27-2.71, p = 0.001).
Conclusion
CT-based radiomic signatures are associated with both HPV status and DFS in OPSCC patients. With additional validation, the radiomic signature and its corresponding nomogram could potentially be used for identifying HPV+ OPSCC patients who might be candidates for therapy deintensification.
Details
- Title: Subtitle
- Radiomic Features Associated With HPV Status on Pretreatment Computed Tomography in Oropharyngeal Squamous Cell Carcinoma Inform Clinical Prognosis
- Creators
- Bolin Song - Case Western Reserve UniversityKailin Yang - Cleveland ClinicJonathan Garneau - University of VirginiaCheng Lu - Case Western Reserve UniversityLin Li - Case Western Reserve UniversityJonathan Lee - Cleveland ClinicSarah Stock - Cleveland ClinicNathaniel M. Braman - Case Western Reserve UniversityCan Fahrettin Koyuncu - Case Western Reserve UniversityPaula Toro - Case Western Reserve UniversityPingfu Fu - Case Western Reserve UniversityShlomo A. Koyfman - Cleveland ClinicJames S. Lewis - Vanderbilt University Medical CenterAnant Madabhushi - Case Western Reserve University
- Resource Type
- Journal article
- Publication Details
- Frontiers in oncology, Vol.11, pp.744250-744250
- Publisher
- Frontiers Media Sa
- DOI
- 10.3389/fonc.2021.744250
- PMID
- 34557418
- PMCID
- PMC8454409
- ISSN
- 2234-943X
- eISSN
- 2234-943X
- Number of pages
- 14
- Grant note
- 1R01HL15127701A1 / National Heart, Lung and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) IBX004121A / VA Merit Review Award; US Department of Veterans Affairs UL1TR0002548 / Clinical and Translational Science Collaborative of Cleveland; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) United States Department of Veterans Affairs Biomedical Laboratory Research and Development Service W81XWH-18-10440; W81XWH-20-1-0595 / Lung Cancer Research Program W81XWH-18-1-0404 / Peer Reviewed Cancer Research Program W81XWH-19-1-0668 / Office of the Assistant Secretary of Defense for Health Affairs, through the Breast Cancer Research Program Kidney Precision Medicine Project (KPMP) Glue Grant National Institutes of Health and NIH roadmap for Medical Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA T32CA094186 / Computational Genomic Epidemiology of Cancer (CoGEC) Program at Case Comprehensive Cancer Center Ohio Third Frontier Technology Validation Fund 1R43EB028736-01 / National Institute for Biomedical Imaging and Bioengineering; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Biomedical Imaging & Bioengineering (NIBIB) W81XWH-15-1-0558; W81XWH-20-1-0851 / Prostate Cancer Research Program 1 C06 RR12463-01 / National Center for Research Resources; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) 1U24CA199374-01; R01 CA24999201A1; R01CA202752-01A1; R01CA208236-01A1; R01CA216579-01A1; R01CA220581-01A1; 1U01CA239055-01; 1U01CA248226-01; 1U54CA254566-01 / National Cancer Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) Wallace H. Coulter Foundation Program in the Department of Biomedical Engineering at Case Western Reserve University
- Language
- English
- Date published
- 09/07/2021
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984696712602771
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