Texture analysis of advanced non-small cell lung cancer (NSCLC) on contrast-enhanced computed tomography: prediction of the response to the first-line chemotherapy

Ravanelli, Marco; Farina, Davide; Morassi, Mauro; Roca, Elisa; Cavalleri, Giuseppe; Tassi, Gianfranco; Maroldi, Roberto
December 2013
European Radiology;Dec2013, Vol. 23 Issue 12, p3450
Academic Journal
Objectives: To assess whether tumour heterogeneity, quantified by texture analysis (TA) on contrast-enhanced computed tomography (CECT), can predict response to chemotherapy in advanced non-small cell lung cancer (NSCLC). Methods: Fifty-three CECT studies of patients with advanced NSCLC who had undergone first-line chemotherapy were retrospectively reviewed. Response to chemotherapy was evaluated according to RECIST1.1. Tumour uniformity was assessed by a TA method based on Laplacian of Gaussian filtering. The resulting parameters were correlated with treatment response and overall survival by multivariate analysis. Results: Thirty-one out of 53 patients were non-responders and 22 were responders. Average overall survival was 13 months (4–35), minimum follow-up was 12 months. In the adenocarcinoma group ( n = 31), the product of tumour uniformity and grey level (GL*U) was the unique independent variable correlating with treatment response. Dividing the GL*U (range 8.5-46.6) into tertiles, lesions belonging to the second and the third tertiles had an 8.3-fold higher probability of treatment response compared with those in the first tertile. No association between texture features and response to treatment was observed in the non-adenocarcinoma group ( n = 22). GL*U did not correlate with overall survival. Conclusions: TA on CECT images in advanced lung adenocarcinoma provides an independent predictive indicator of response to first-line chemotherapy. Key Points: • Contrast enhanced computed tomography is currently used to stage lung cancer.• Texture analysis allows tumour heterogeneity to be quantified on CT images.• Texture parameters seem to predict chemotherapy response in advanced NSCLC.


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