Computed tomography-based delta-radiomics analysis for discriminating radiation pneumonitis in patients with esophageal cancer after radiation therapy

Abstract Objectives We aimed to assess extracellular volume (ECV) through non-gated, contrast-enhanced computed tomography (CT) before and after radiation therapy (RT) in patients with esophageal cancer (EC). Materials and methods EC patients who had undergone CT before and after RT were retrospectively assessed. Patients with preexisting cardiovascular disease or with heavily artifacted CT were excluded. ECV was calculated using density values for the myocardial septum and blood pool. Data were reported as mean and standard deviation or median and interquartile range according to their distribution; t test or Wilcoxon and Pearson r or Spearman ρ were subsequently used. Results Twenty-one patients with stage ≥ IB EC, aged 64 ± 18 years, were included. Mean and maximum RT doses were 21.2 Gy (16.9–24.1) and 42.5 Gy (41.8–49.2), respectively. At baseline (n = 21), hematocrit was 39% ± 4%, ECV 27.9% ± 3.5%; 35 days (30–38) after RT (n = 20), hematocrit was 36% ± 4%, lower than at baseline (p = 0.002), ECV 30.3% ± 8.3%, higher than at baseline (p = 0.081); at follow-up 420 days (244–624) after RT (n = 13), hematocrit was 36% ± 5%, lower than at baseline (p = 0.030), ECV 31.4% ± 4.5%, higher than at baseline (p = 0.011). No patients showed signs of overt cardiotoxicity. ECV early after RT was moderately positively correlated with maximum RT dose (ρ = 0.50, p = 0.036). Conclusions In EC patients, CT-derived myocardial ECV was increased after RT and may thus appear as a potential early biomarker of cardiotoxicity.

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Biological dosiomic features for the prediction of radiation pneumonitis in esophageal cancer patients

Radiation Oncology ◽

10.1186/s13014-021-01950-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Chanon Puttanawarut ◽

Nat Sirirutbunkajorn ◽

Suphalak Khachonkham ◽

Poompis Pattaranutaporn ◽

Yodchanan Wongsawat

Keyword(s):

Esophageal Cancer ◽

Radiation Therapy ◽

Predictive Model ◽

Cancer Patients ◽

Operating Characteristic ◽

Radiation Pneumonitis ◽

Dose Volume Histogram ◽

L1 Norm ◽

Receiver Operating Characteristic Curves ◽

Dose Volume

Abstract Objective The purpose of this study was to develop a model using dose volume histogram (DVH) and dosiomic features to predict the risk of radiation pneumonitis (RP) in the treatment of esophageal cancer with radiation therapy and to compare the performance of DVH and dosiomic features after adjustment for the effect of fractionation by correcting the dose to the equivalent dose in 2 Gy (EQD2). Materials and methods DVH features and dosiomic features were extracted from the 3D dose distribution of 101 esophageal cancer patients. The features were extracted with and without correction to EQD2. A predictive model was trained to predict RP grade ≥ 1 by logistic regression with L1 norm regularization. The models were then evaluated by the areas under the receiver operating characteristic curves (AUCs). Result The AUCs of both DVH-based models with and without correction of the dose to EQD2 were 0.66 and 0.66, respectively. Both dosiomic-based models with correction of the dose to EQD2 (AUC = 0.70) and without correction of the dose to EQD2 (AUC = 0.71) showed significant improvement in performance when compared to both DVH-based models. There were no significant differences in the performance of the model by correcting the dose to EQD2. Conclusion Dosiomic features can improve the performance of the predictive model for RP compared with that obtained with the DVH-based model.

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Corrigendum: Correlation Between Lung Density Changes Under Different Dose Gradients and Radiation Pneumonitis—Based on an Analysis of Computed Tomography Scans During Esophageal Cancer Radiotherapy

Frontiers in Oncology ◽

10.3389/fonc.2021.786217 ◽

2021 ◽

Vol 11 ◽

Author(s):

Feng Du ◽

Hong Liu ◽

Wei Wang ◽

Yingjie Zhang ◽

Jianbin Li

Keyword(s):

Computed Tomography ◽

Esophageal Cancer ◽

Radiation Pneumonitis ◽

Lung Density ◽

Cancer Radiotherapy ◽

Computed Tomography Scans

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Correlation Between Lung Density Changes Under Different Dose Gradients and Radiation Pneumonitis—Based on an Analysis of Computed Tomography Scans During Esophageal Cancer Radiotherapy

Frontiers in Oncology ◽

10.3389/fonc.2021.650764 ◽

2021 ◽

Vol 11 ◽

Author(s):

Feng Du ◽

Hong Liu ◽

Wei Wang ◽

Yingjie Zhang ◽

Jianbin Li

Keyword(s):

Computed Tomography ◽

Esophageal Cancer ◽

Radiation Dose ◽

Correlation Coefficient ◽

Radiation Pneumonitis ◽

Regression Coefficient ◽

Lung Density ◽

Occurrence Time ◽

Planning Ct ◽

Different Doses

PurposeTo assess the relationship between different doses of radiation and lung density changes and to determine the ability of this correlation to identify esophageal cancer (EC) patients who develop radiation pneumonitis (RP) and the occurrence time of RP.MethodsA planning computed tomography (CT) scan and a re-planning CT scan were retrospectively collected under institutional review board approval for each of 103 thoracic segment EC patients who underwent radiotherapy (RT). The isodose curve was established on the planning CT with an interval of 5 Gy, which was used as the standard for dividing different gradient doses. Planning CT and re-planning CT scans were matched and the mean lung CT value (HU) between different doses gradients was automatically obtained by the software system. The density change value (ΔHU) was the difference of CT value between each dose gradient before and after treatment. The correlation between ΔHU and the corresponding dose was calculated, as well as the regression coefficients. Additionally the correlation between ΔHU and the occurrence and time of RP (< 4 weeks, 4–12 weeks, > 12 weeks) was calculated.ResultsThe radiation dose and ΔHU was positively correlated, but the correlation coefficient and regression coefficient were lower, 0.261 (P <0.001) and 0.127 (P <0.001), respectively. With the increase of radiation dose gradient, ΔHU in RP≥2 group was higher than that in RP<2 group, and there was significant difference between two groups in ΔHU20-25, ΔHU25-30, ΔHU30-35, ΔHU35-40, ΔHU40-45, ΔHU45-50 (p<0.05). The occurrence time of RP was negatively correlated with the degree of ΔHU (P<0.05), with a high correlation coefficient (Y = week actual value −0.521, P < 0.001) (Y = week grade value −0.381, P = 0.004) and regression coefficient (Y = week actual value −0.503, P<0.001) (Y = week rating value −0.401, P=0.002).ConclusionsA relationship between radiation dose and lung density changes was observed. For most dose intervals, there was an increase of ΔHU with an increased radiation dose, although low correlation coefficient. ΔHU were obvious after irradiation with dose ≥20 Gy which was closely related to the occurrence of RP. For patients with RP, the more obvious ΔHU, the earlier the occurrence of RP, there was a significant negative correlation between them.

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