Prognostic role of pre-treatment magnetic resonance imaging (MRI)-based radiomic analysis in effectively cured head and neck squamous cell carcinoma (HNSCC) patients

Authors

  • Salvatore Alfieri Head and Neck Cancer Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
  • Rebecca Romanò Head and Neck Cancer Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
  • Marco Bologna Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
  • Giuseppina Calareso Radiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
  • Valentina Corino Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
  • Aurora Mirabile Department of Oncology, Division of Experimental Medicine, IRCCS San Raffaele Hospital, Milan, Italy
  • Andrea Ferri Department of Surgery, Maxillo-Facial Surgery Division, University Hospital of Parma, Parma, Italy
  • Luca Bellanti Department of Surgery, Maxillo-Facial Surgery Division, University Hospital of Parma, Parma, Italy
  • Tito Poli Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), Unit of Maxillo-Facial Surgery, University of Parma, Parma, Italy
  • Alessandra Marcantoni ENT Department, Santa Chiara Hospital, Trento, Italy
  • Enrica Grosso Division of Head and Neck Surgery, Istituto Europeo di Oncologia (IEO), Milan, Italy
  • Achille Tarsitano Department of Biomedical and Neuromotor Sciences, Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
  • Salvatore Battaglia Department of Biomedical and Neuromotor Sciences, Maxillofacial Surgery Unit, S. Orsola-Malpighi Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
  • Fulvia Blengio Medical Oncology Department, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
  • Iolanda De Martino Medical Oncology Department, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
  • Sara Valerini Neuroscience Head and Neck Department, Otolaryngology Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
  • Stefania Vecchio Medical Oncology 2, IRCCS Ospedale Policlinico San Martino, Genova, Italy
  • Antonella Richetti Radiation Oncology Clinic Oncology, Institute of Southern Switzerland (IOSI), Bellinzona-Lugano, Switzerland
  • Letizia Deantonio Radiation Oncology Clinic Oncology, Institute of Southern Switzerland (IOSI), Bellinzona-Lugano, Switzerland
  • Francesco Martucci Radiation Oncology Clinic Oncology, Institute of Southern Switzerland (IOSI), Bellinzona-Lugano, Switzerland
  • Alberto Grammatica Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, Unit of Otorhinolaryngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
  • Marco Ravanelli Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Unit of Radiology, University of Brescia, Brescia, Italy
  • Toni Ibrahim Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
  • Damiano Caruso Department of Surgical and Medical Sciences and Translational Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Rome, Italy
  • Laura Deborah Locati Head and Neck Cancer Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
  • Ester Orlandi Radiotherapy Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
  • Paolo Bossi Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public, Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
  • Luca Mainardi Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
  • Lisa F. Licitra Head and Neck Cancer Medical Oncology 3 Department, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy;t University of Milan, Milan, Italy

DOI:

https://doi.org/10.1080/0284186X.2021.1924401

Keywords:

Radiomic, magnetic resonance imaging (MRI), pretreatment, prognostic, predictive, recurrence, head and neck squamous cell carcinoma

Abstract

Objectives

To identify and validate baseline magnetic resonance imaging (b-MRI) radiomic features (RFs) as predictors of disease outcomes in effectively cured head and neck squamous cell carcinoma (HNSCC) patients.

Materials and methods

Training set (TS) and validation set (VS) were retrieved from preexisting datasets (HETeCo and BD2Decide trials, respectively). Only patients with both pre- and post-contrast enhancement T1 and T2-weighted b-MRI and at least 2 years of follow-up (FUP) were selected. The combination of the best extracted RFs was used to classify low risk (LR) vs. high risk (HR) of disease recurrence. Sensitivity, specificity, and area under the curve (AUC) of the radiomic model were computed on both TS and VS. Overall survival (OS) and 5-year disease-free survival (DFS) Kaplan–Meier (KM) curves were compared for LR vs. HR. The radiomic-based risk class was used in a multivariate Cox model, including well-established clinical prognostic factors (TNM, sub-site, human papillomavirus [HPV]).

Results

In total, 57 patients of TS and 137 of VS were included. Three RFs were selected for the signature. Sensitivity of recurrence risk classifier was 0.82 and 0.77, specificity 0.78 and 0.81, AUC 0.83 and 0.78 for TS and VS, respectively. VS KM curves for LR vs. HR groups significantly differed both for 5-year DFS (p<.0001) and OS (p=.0004). A combined model of RFs plus TNM improved prognostic performance as compared to TNM alone, both for VS 5-year DFS (C-index: 0.76 vs. 0.60) and OS (C-index: 0.74 vs. 0.64).

Conclusions

Radiomics of b-MRI can help to predict recurrence and survival outcomes in HNSCC.

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Additional Files

Published

2021-09-02

How to Cite

Alfieri, S. ., Romanò, R. ., Bologna, M. ., Calareso, G. ., Corino, V. ., Mirabile, A. ., … Licitra, L. F. . (2021). Prognostic role of pre-treatment magnetic resonance imaging (MRI)-based radiomic analysis in effectively cured head and neck squamous cell carcinoma (HNSCC) patients. Acta Oncologica, 60(9), 1192–1200. https://doi.org/10.1080/0284186X.2021.1924401

Issue

Vol. 60 No. 9 (2021): Acta Oncologica

Section

Articles