Radiomic texture analysis correlates with PDAC patient outcomes on SM-88.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16776-e16776
Author(s):  
Allyson J. Ocean ◽  
Ronald Lee Korn ◽  
Semmie Kim ◽  
Andre Burkett ◽  
Ziad Hindosh ◽  
...  
Keyword(s):  
Region Of Interest ◽  
Tumor Diameter ◽  
Portal Venous Phase ◽  
Prior Therapy ◽  
Coarse Texture ◽  
Size Number ◽  
Phase Images ◽  
Venous Phase ◽  
Textural Changes ◽  
Ecog Ps

e16776 Background: SM-88 (racemetyrosine) is a dysfunctional tyrosine derivative; previous studies demonstrated a well-tolerated profile with encouraging efficacy. Recent advances in image analysis using Quantitative Textural Analysis (QTA) have uncovered non-invasive biomarkers that correlate with molecular drivers of cancer and prognostic signatures of response in PDAC. Earlier radiomic data from subjects treated with SM-88 showed a positive correlation between circulating tumor cells and tumor texture at baseline. This study extends those findings to focus on radiomic changes associated with SM-88 doses in a Phase II dose escalation trial (NCT03512756). Methods: Retrospective evaluation of 18 subjects with >1 prior therapy, ECOG PS <2, with no restriction on size, number, or locations of mets, and had baseline (BL) and follow up (FUP) contrast enhanced CTs. Subjects received > 1 cycle of SM-88 at either 460mg (n = 8) or 920mg (n = 10) QD oral doses. CTs were analyzed by the QTA platform (TexRad, Essex, UK) for tumor texture. The largest met of each subject was selected using portal venous phase images. A region of interest was posited on the axial slice with the longest tumor diameter and features automatically generated using voxel resampling to correct for scanner variability across subjects and time points. Results were displayed as histogram frequency curves (HFCs) of pixel densities (Hounsfield Units). First order HFC analysis (mean, StDev, MPP, skewness, kurtosis) at spatial scale filters (SSF) ranging from no filter, to fine, to coarse texture (SSF:0, SSF:2, SSF:6, respectively) were reported. Results: Subjects whose largest lesions showed greater changes in tumor texture at FUP vs. BL were more likely to develop tumor progression (StDev in PD (n = 10) vs SD (n = 7) (1 N/A): -0.07 vs -0.25, p = 0.05). Greater tumor textural changes were associated with poor survival at 180 days (Skewness: Chi-Sq. = 4.81, p = 0.03; HR = 4.1 for above median □Skewssf3). There was a negative change in FUP kurtosis vs BL in the 6 subjects who developed new lesions vs the 12 who did not (mean □kurtosis = -0.67 vs +2.63, p = 0.05). Greater change in tumor texture on FUP vs BL scans was seen in the 460mg vs 920mg group (MPPLD = -0.29, MPPHD = -0.04; p = 0.05) suggesting more tumor stability (less change in texture and better outcomes) was associated with the 920mg dose. Conclusions: Tumor lesions in subjects on 920mg of SM-88 were less likely to show a change in tumor texture and were associated with better outcomes. Using radiomic QTA, less tumor texture variability from baseline may be associated with better outcomes in PDAC subjects.

Case 2.23

2014 ◽  
pp. 107-107
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Liver Disease ◽  
Signal Intensity ◽  
Phase Image ◽  
Hepatobiliary Phase ◽  
Portal Venous Phase ◽  
Hepatic Lobe ◽  
Phase Images ◽  
Venous Phase ◽  
The Right ◽  
Multiple Nodules

55-year-old woman with chronic liver disease Axial fat-suppressed FSE T2-weighted images (Figure 2.23.1) demonstrate a cirrhotic liver with diffuse, innumerable, small low-signal-intensity nodules. Axial arterial, portal venous, and hepatobiliary phase postgadolinium (Eovist) 3D SPGR images (Figure 2.23.2) demonstrate heterogeneous enhancement of the background parenchyma, particularly in the right hepatic lobe. The multiple nodules are initially hypointense on arterial and portal venous phase images but become hyperintense relative to adjacent liver on the hepatobiliary phase image....

scholarly journals Abdominal vessel depiction on virtual triphasic spectral detector CT: initial clinical experience

2021 ◽  
Author(s):  
Simon Lennartz ◽  
Kai Roman Laukamp ◽  
Yasmeen Tandon ◽  
Michelle Jordan ◽  
Nils Große Hokamp ◽  
...  
Keyword(s):  
Vena Cava ◽  
Region Of Interest ◽  
Qualitative Assessment ◽  
Arterial Phase ◽  
Phase Images ◽  
Spectral Detector Ct ◽  
Venous Phase ◽  
Significant Attenuation ◽  
Virtual Monoenergetic Images ◽  
Contrast Information

Abstract Purpose To evaluate vessel assessment in virtual monoenergetic images (VMI40keV) and virtual-non-contrast images (VNC) derived from venous phase spectral detector computed tomography (SDCT) acquisitions in comparison to arterial phase and true non-contrast (TNC) images. Methods Triphasic abdominal SDCT was performed in 25 patients including TNC, arterial and venous phase. VMI40keV and VNC were reconstructed from the venous phase and compared to conventional arterial-phase images (CIart), TNC and conventional venous-phase images (CIven). Vessel contrast and virtual contrast removal were analyzed with region-of-interest-based measurements and in a qualitative assessment. Results Quantitative analysis revealed no significant attenuation differences between TNC and VNC in arterial vessels (p-range 0.07–0.47) except for the renal artery (p = 0.011). For venous vessels, significant differences between TNC and VNC were found for all veins (p < 0.001) except the inferior vena cava (p = 0.26), yet these differences remained within a 10 HU range in most patients. No significant attenuation differences were found between CIart/VMI40keV in arterial vessels (p-range 0.06–0.86). Contrast-to-noise ratio provided by VMI40keV and CIart was equivalent for all arterial vessels assessed (p-range 0.14–0.91). Qualitatively, VMI40keV showed similar enhancement of abdominal and pelvic arteries as CIart and VNC were rated comparable to TNC. Conclusion Our study suggests that VNC and VMI40keV derived from single venous-phase SDCT offer comparable assessment of major abdominal vessels as provided by routine triphasic examinations, if no dynamic contrast information is required.

Case 17.17

2014 ◽  
pp. 821-822
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Arterial Phase ◽  
Portal Venous Phase ◽  
Phase Images ◽  
Signal Void ◽  
Venous Phase

58-year-old woman with cirrhosis Axial precontrast (Figure 17.17.1) and arterial phase (Figure 17.17.2) and portal venous phase (Figure 17.17.3) postgadolinium water and fat images from a 3D SPGR Dixon acquisition. Notice that the phase and frequency directions have been swapped on the arterial phase acquisition and that there is a large geographic signal void in the middle of the liver on the water image, with the missing anatomy appearing on the corresponding fat image. All artifacts have been corrected on the portal venous phase images....

Case 2.16

2014 ◽  
pp. 92-93 ◽  
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Superior Mesenteric Vein ◽  
Main Portal Vein ◽  
Portal Venous Phase ◽  
Phase Images ◽  
Venous Phase ◽  
Portal Veins ◽  
The Right ◽  
Oblique Images

83-year-old man being evaluated in the emergency department for abdominal pain Axial postgadolinium portal venous phase images (Figure 2.16.1) demonstrate nearly occlusive thrombus throughout the main portal vein. Reformatted oblique images (Figure 2.16.2) show thrombus extension into the right and left portal veins and the superior mesenteric vein....

scholarly journals Non-contrast and portal venous phase computed tomography in breast cancer hepatic metastases: comparison of tumor measurements and impact on response assessment

2021 ◽  
Vol 10 (2) ◽  
pp. 205846012199801
Author(s):  
Brian Flemming ◽  
Mark D Kovacs ◽  
Andrew Hardie ◽  
Melissa Picard ◽  
Philip F Burchett ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Computed Tomography ◽  
Hepatic Metastases ◽  
Lesion Size ◽  
Breast Cancer Patients ◽  
Contrast Imaging ◽  
Post Contrast ◽  
Portal Venous Phase ◽  
Phase Images ◽  
Venous Phase

Background For many common malignancies, including breast cancer, evaluation for metastatic disease using multiphase computed tomography (CT) has fallen out of favor and been replaced by studies performed only in the portal venous phase. However, differences in tumor vascularity could produce differences in appearance on post-contrast imaging. Purpose To assess non-contrast phase and portal venous phase computed tomography in detection and measurement of hepatic metastases from breast carcinoma. Materials and Methods A total of 75 CT scans from 52 breast cancer patients were independently assessed by three body imagers for lesion presence, number and size. Readers randomly assessed portal venous phase or combined phase images at one session with cross-over reads performed four to six weeks later. Results In the 58% of cases where index lesions measured larger on combined phase, the mean difference in lesion size was 5.7 mm. In this group, combined phase reads demonstrated an 8.4 mm increase in sum of largest diameters, and a mean percentage sum of largest diameters increase of 19% compared to portal venous phase-only reads. Conclusion Addition of non-contrast phase images results in increased index lesion size in most patients with hepatic metastases from breast cancer. If only the portal venous phase is utilized, there is potential for incorrectly diagnosing disease progression on follow-up due to underestimation of lesion size.

scholarly journals The utility of a dual-phase, dual-energy CT protocol in patients presenting with overt gastrointestinal bleeding

2021 ◽  
Vol 10 (7) ◽  
pp. 205846012110306
Author(s):  
Payam Mohammadinejad ◽  
Lukasz Kwapisz ◽  
Jeff L Fidler ◽  
Shannon P Sheedy ◽  
Jay P Heiken ◽  
...  
Keyword(s):  
Dual Energy ◽  
Arterial Phase ◽  
Gi Bleeding ◽  
Two Phase ◽  
Portal Venous Phase ◽  
Portal Phase ◽  
Ct Protocol ◽  
Phase Images ◽  
Venous Phase ◽  
Gi Bleed

Background Due to their easy accessibility, CT scans have been increasingly used for investigation of gastrointestinal (GI) bleeding. Purpose To estimate the performance of a dual-phase, dual-energy (DE) GI bleed CT protocol in patients with overt GI bleeding in clinical practice and examine the added value of portal phase and DE images. Materials and Methods Consecutive patients with GI bleeding underwent a two-phase DE GI bleed CT protocol. Two gastroenterologists established the reference standard. Performance was estimated using clinical CT reports. Three GI radiologists rated confidence in GI bleeding in a subset of 62 examinations, evaluating first mixed kV arterial images, then after examining additional portal venous phase images, and finally after additional DE images (virtual non-contrast and virtual monoenergetic 50 keV images). Results 52 of 176 patients (29.5%) had GI bleeding by the reference standard. The overall sensitivity, specificity, and positive and negative predictive values of the CT GI bleed protocol for detecting GI bleeding were 65.4%, 89.5%, 72.3%, and 86.0%, respectively. In patients with GI bleeding, diagnostic confidence of readers increased after adding portal phase images to arterial phase images ( p = 0.002), without additional benefit from dual energy images. In patients without GI bleeding, confidence in luminal extravasation appropriately decreased after adding portal phase, and subsequently DE images ( p = 0.006, p = 0.018). Conclusion A two-phase DE GI bleed CT protocol had high specificity and negative predictive value in clinical practice. Portal venous phase images improved diagnostic confidence in comparison to arterial phase images alone. Dual-energy images further improved radiologist confidence in the absence of bleeding.

scholarly journals Value of contrast-enhanced CT texture analysis in predicting IDH mutation status of intrahepatic cholangiocarcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Zhu ◽  
Yingfan Mao ◽  
Jun Chen ◽  
Yudong Qiu ◽  
Yue Guan ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Ct Images ◽  
Textural Features ◽  
Mutation Status ◽  
Portal Venous Phase ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Venous Phase ◽  
Ct Texture Analysis

AbstractTo explore the value of contrast-enhanced CT texture analysis in predicting isocitrate dehydrogenase (IDH) mutation status of intrahepatic cholangiocarcinomas (ICCs). Institutional review board approved this study. Contrast-enhanced CT images of 138 ICC patients (21 with IDH mutation and 117 without IDH mutation) were retrospectively reviewed. Texture analysis was performed for each lesion and compared between ICCs with and without IDH mutation. All textural features in each phase and combinations of textural features (p < 0.05) by Mann–Whitney U tests were separately used to train multiple support vector machine (SVM) classifiers. The classification generalizability and performance were evaluated using a tenfold cross-validation scheme. Among plain, arterial phase (AP), portal venous phase (VP), equilibrium phase (EP) and Sig classifiers, VP classifier showed the highest accuracy of 0.863 (sensitivity, 0.727; specificity, 0.885), with a mean area under the receiver operating characteristic curve of 0.813 in predicting IDH mutation in validation cohort. Texture features of CT images in portal venous phase could predict IDH mutation status of ICCs with SVM classifier preoperatively.

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