Association between morphologic CT imaging traits and prognostically relevant gene signatures in women with high-grade serous ovarian cancer: a hypothesis-generating study.
OBJECTIVE
To investigate associations among imaging traits observed on computed tomographic (CT) images, Classification of Ovarian Cancer (CLOVAR) gene signatures, and survival in women with high-grade serous ovarian cancer (HGSOC).


METHODS
The institutional review board approved this HIPAA-compliant retrospective study of CT images obtained before cytoreductive surgery in 46 women with HGSOC, whose tumors were subjected to molecular analysis performed by the Cancer Genome Atlas Research Network. Two readers independently evaluated the CT features of the primary ovarian mass and sites of metastatic spread if present, including size, outline, and texture. Fisher exact test was used to examine the relationship between imaging traits and CLOVAR subtypes (CLOVAR differentiated, immunoreactive, mesenchymal, and proliferative). Kaplan-Meier and Cox proportional hazards regression survival analyses were performed.


RESULTS
The presence of mesenteric infiltration and diffuse peritoneal involvement by tumor at CT were significantly associated with CLOVAR subtype (P = .002-.004 for reader 1 and P = .005-.012 for reader 2). Mesenteric infiltration at CT was associated with CLOVAR mesenchymal subtype. Patients with mesenteric infiltration had shorter median progression-free survival than patients without mesenteric involvement (14.7 months vs 25.6 months according to both readers; P = .019 for reader 1 and .015 for reader 2) and overall survival (49.0 vs 58.2 months; P = .014 [reader 1] and 50.0 vs 59.1 months; P = .015 [reader 2]). No other imaging features were significantly associated with CLOVAR subtype or survival.


CONCLUSIONS
Specific CT imaging traits were associated with the CLOVAR subtypes and survival in patients with HGSOC.
From the Departments of Radiology (H.A.V., M.M., S.I.H., H.H., E.S.), Epidemiology and Biostatistics (D.A.G.), Surgery (F.D., D.A.L.), and Pathology (B.W., R.A.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Room C278, New York, NY 10065.
Hebert Alberto
HA
Vargas
Maura
M
Miccò
Seong Im
SI
Hong
Debra A
DA
Goldman
Fanny
F
Dao
Britta
B
Weigelt
Robert A
RA
Soslow
Hedvig
H
Hricak
Douglas A
DA
Levine
Evis
E
Sala
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D059467:Transcriptome