Peritumoral and intratumoral radiomic features predict survival outcomes among patients diagnosed in lung cancer screening

Sci Rep. 2020 Jun 29;10(1):10528. doi: 10.1038/s41598-020-67378-8.

Abstract

The National Lung Screening Trial (NLST) demonstrated that screening with low-dose computed tomography (LDCT) is associated with a 20% reduction in lung cancer mortality. One potential limitation of LDCT screening is overdiagnosis of slow growing and indolent cancers. In this study, peritumoral and intratumoral radiomics was used to identify a vulnerable subset of lung patients associated with poor survival outcomes. Incident lung cancer patients from the NLST were split into training and test cohorts and an external cohort of non-screen detected adenocarcinomas was used for further validation. After removing redundant and non-reproducible radiomics features, backward elimination analyses identified a single model which was subjected to Classification and Regression Tree to stratify patients into three risk-groups based on two radiomics features (NGTDM Busyness and Statistical Root Mean Square [RMS]). The final model was validated in the test cohort and the cohort of non-screen detected adenocarcinomas. Using a radio-genomics dataset, Statistical RMS was significantly associated with FOXF2 gene by both correlation and two-group analyses. Our rigorous approach generated a novel radiomics model that identified a vulnerable high-risk group of early stage patients associated with poor outcomes. These patients may require aggressive follow-up and/or adjuvant therapy to mitigate their poor outcomes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenocarcinoma of Lung / diagnostic imaging*
  • Adenocarcinoma of Lung / genetics
  • Adenocarcinoma of Lung / mortality
  • Aged
  • Early Detection of Cancer
  • Female
  • Forkhead Transcription Factors / genetics
  • Humans
  • Lung / diagnostic imaging*
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / mortality
  • Male
  • Mass Screening
  • Middle Aged
  • Prognosis
  • Survival Rate
  • Tomography, X-Ray Computed

Substances

  • FOXF2 protein, human
  • Forkhead Transcription Factors