Prediction of the therapeutic response after FOLFOX and FOLFIRI treatment for patients with liver metastasis from colorectal cancer using computerized CT texture analysis.
OBJECTIVE
To determine whether baseline CT texture analysis of hepatic metastasis from colorectal cancer (CRC) is predictive of therapeutic response after cytotoxic chemotherapy.


METHODS
235 patients with liver metastasis from CRC who underwent CT and cytotoxic chemotherapy using FOLFOX and FOLFIRI were divided into derivation cohort (n=145) and validation cohort (n=90). The CT texture of the hepatic metastasis was quantified using baseline CT. We analyzed the independent predictor for the response from derivation cohort and validated it using validation cohort. We also compared texture features between included four CT scanners.


RESULTS
89 responding and 146 non-responding patients were evaluated. In the derivation cohort, lower skewness (OR, 6.739) in 2D, higher mean attenuation (OR, 2.587), and narrower standard deviation (SD) (OR, 3.163) in 3D were independently associated with response to chemotherapy. However, only lower skewness (P=0.213) on 2D and narrower SD on 3D analysis (P=0.097) did not show a significant difference on either CT scanner. When applied to the validation set, the lower skewness on 2D (AUC=0.797) and narrower SD on 3D (AUC=0.785) showed good performance.


CONCLUSIONS
CT texture analysis is useful for prediction of therapeutic response after cytotoxic chemotherapy in patients with liver metastasis from colorectal cancer.
Department of Radiology, Seoul National University Hospital, Seoul, South Korea. Electronic address: joa0827@gmail.com.
Su Joa
SJ
Ahn
Department of Radiology, Seoul National University Hospital, Seoul, South Korea; Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: jhkim2008@gmail.com.
Jung Hoon
JH
Kim
Department of Radiology, Seoul National University Hospital, Seoul, South Korea; Cancer Research Institute, Seoul National University, Seoul, South Korea. Electronic address: lunao78@naver.com.
Sang Joon
SJ
Park
Department of Radiology, Seoul National University Hospital, Seoul, South Korea; Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: hanjk@snu.ac.kr.
Joon Koo
JK
Han
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
CT; Cytotoxic chemotherapy; Hepatic metastasis from colorectal cancer; Texture analysis; Therapeutic response