title: Quantitative measurement of adiposity using CT images to predict the benefit of bevacizumab-based chemotherapy in epithelial ovarian cancer patients.
abstract: The present study aims to quantitatively measure adiposity-related image features and to test the feasibility of applying multivariate statistical data analysis-based prediction models to generate a novel clinical marker and predict the benefit of epithelial ovarian cancer (EOC) patients with and without maintenance bevacizumab-based chemotherapy. A dataset involving computed tomography (CT) images acquired from 59 patients diagnosed with advanced EOC was retrospectively collected. Among them, 32 patients received maintenance bevacizumab following primary chemotherapy, while 27 did not. A computer-aided detection scheme was developed to automatically segment visceral and subcutaneous fat areas depicted on CT images of abdominal sections, and 7 adiposity-related image features were computed. Upon combining these features with the measured body mass index, multivariate data analyses were performed using three statistical models (multiple linear, logistic and Cox proportional hazards regressions) to analyze the association between the model-generated prediction results and the treatment outcome, including progression-free survival (PFS) and overall survival (OS) of the patients. The results demonstrated that applying all three prediction models yielded a significant association between the adiposity-related image features and patients' PFS or OS in the group of the patients who received maintenance bevacizumab (P<0.010), while there was no significant difference when these prediction models were applied to predict both PFS and OS in the group of patients that did not receive maintenance bevacizumab. Therefore, the present study demonstrated that the use of a quantitative adiposity-related image feature-based statistical model may generate a novel clinical marker to predict who will benefit among EOC patients receiving maintenance bevacizumab-based chemotherapy.
authors.affiliation: School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, USA.
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Health Science Center of University of Oklahoma, Oklahoma, OK 73104, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Thai
authors.affiliation: Health Science Center of University of Oklahoma, Oklahoma, OK 73104, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Moore
authors.affiliation: Health Science Center of University of Oklahoma, Oklahoma, OK 73104, USA.
authors.forename: Kai
authors.initials: K
authors.lastname: Ding
authors.affiliation: Health Science Center of University of Oklahoma, Oklahoma, OK 73104, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: McMeekin
authors.affiliation: School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, USA.
authors.forename: Bin
authors.initials: B
authors.lastname: Zheng
keywords: bevacizumab-based chemotherapy; clinical marker of prognosis; computer-aided detection; epithelial ovarian cancer; multivariate statistical data analysis; quantitative image feature analysis