title: Defining a Radiomic Response Phenotype: A Pilot Study using targeted therapy in NSCLC.
abstract: Medical imaging plays a fundamental role in oncology and drug development, by providing a non-invasive method to visualize tumor phenotype. Radiomics can quantify this phenotype comprehensively by applying image-characterization algorithms, and may provide important information beyond tumor size or burden. In this study, we investigated if radiomics can identify a gefitinib response-phenotype, studying high-resolution computed-tomography (CT) imaging of forty-seven patients with early-stage non-small cell lung cancer before and after three weeks of therapy. On the baseline-scan, radiomic-feature Laws-Energy was significantly predictive for EGFR-mutation status (AUC = 0.67, p = 0.03), while volume (AUC = 0.59, p = 0.27) and diameter (AUC = 0.56, p = 0.46) were not. Although no features were predictive on the post-treatment scan (p > 0.08), the change in features between the two scans was strongly predictive (significant feature AUC-range = 0.74-0.91). A technical validation revealed that the associated features were also highly stable for test-retest (mean ± std: ICC = 0.96 ± 0.06). This pilot study shows that radiomic data before treatment is able to predict mutation status and associated gefitinib response non-invasively, demonstrating the potential of radiomics-based phenotyping to improve the stratification and response assessment between tyrosine kinase inhibitors (TKIs) sensitive and resistant patient populations.
authors.affiliation: Departments of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Departments of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Departments of Biostatistics &Computational Biology Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Hugo J W L
authors.initials: HJ
authors.lastname: Aerts
authors.affiliation: Departments of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Departments of Biostatistics &Computational Biology Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Grossmann
authors.affiliation: Departments of Radiology Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Department of Medicine, Departments of Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Geoffrey R
authors.initials: GR
authors.lastname: Oxnard
authors.affiliation: Department of Medicine, Division of Oncology Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Naiyer
authors.initials: N
authors.lastname: Rizvi
authors.affiliation: Departments of Radiology Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.affiliation: Departments of Radiology Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Binsheng
authors.initials: B
authors.lastname: Zhao
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D066246:ErbB Receptors; D005260:Female; D005500:Follow-Up Studies; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000628:therapy; D008297:Male; D009154:Mutation; D020360:Neoadjuvant Therapy; D010865:Pilot Projects; D011799:Quinazolines / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
chemical_list: D011799:Quinazolines; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib