PDF(Pubmed)
Abstract：
To develop a comprehensive PET radiomics model to predict the pathological response after neoadjuvant toripalimab with chemotherapy in resectable stage III non-small-cell lung cancer (NSCLC) patients.
Stage III NSCLC patients who received three cycles of neoadjuvant toripalimab with chemotherapy and underwent 18F-FDG PET/CT were enrolled. Baseline 18F-FDG PET/CT was performed before treatment, and preoperative 18F-FDG PET/CT was performed three weeks after the completion of neoadjuvant treatment. Surgical resection was performed 4-5 weeks after the completion of neoadjuvant treatment. Standardized uptake value (SUV) statistics features and radiomics features were derived from baseline and preoperative PET images. Delta features were derived. The radiologic response and metabolic response were assessed by iRECIST and iPERCIST, respectively. The correlations between PD-L1 expression, driver-gene status, peripheral blood biomarkers, and the pathological responses (complete pathological response [CPR]; major pathological response [MPR]) were assessed. Associations between PET features and pathological responses were evaluated by logistic regression.
Thirty patients underwent surgery and 29 of them performed preoperative PET/CT. Twenty patients achieved MPR and 16 of them achieved CPR. In univariate analysis, five SUV statistics features and two radiomics features were significantly associated with pathological responses. In multi-variate analysis, SUVmax, SUVpeak, SULpeak, and End-PET-GLDM-LargeDependenceHighGrayLevelEmphasis (End-GLDM-LDHGLE) were independently associated with CPR. SUVpeak and SULpeak performed better than SUVmax and SULmax for MPR prediction. No significant correlation, neither between the radiologic response and the pathological response, nor among PD-L1, driver gene status, and baseline PET features was found. Inflammatory response biomarkers by peripheral blood showed no difference in different treatment responses.
The logistic regression model using comprehensive PET features contributed to predicting the pathological response after neoadjuvant toripalimab with chemotherapy in resectable stage III NSCLC patients.
Stage III NSCLC patients who received three cycles of neoadjuvant toripalimab with chemotherapy and underwent 18F-FDG PET/CT were enrolled. Baseline 18F-FDG PET/CT was performed before treatment, and preoperative 18F-FDG PET/CT was performed three weeks after the completion of neoadjuvant treatment. Surgical resection was performed 4-5 weeks after the completion of neoadjuvant treatment. Standardized uptake value (SUV) statistics features and radiomics features were derived from baseline and preoperative PET images. Delta features were derived. The radiologic response and metabolic response were assessed by iRECIST and iPERCIST, respectively. The correlations between PD-L1 expression, driver-gene status, peripheral blood biomarkers, and the pathological responses (complete pathological response [CPR]; major pathological response [MPR]) were assessed. Associations between PET features and pathological responses were evaluated by logistic regression.
Thirty patients underwent surgery and 29 of them performed preoperative PET/CT. Twenty patients achieved MPR and 16 of them achieved CPR. In univariate analysis, five SUV statistics features and two radiomics features were significantly associated with pathological responses. In multi-variate analysis, SUVmax, SUVpeak, SULpeak, and End-PET-GLDM-LargeDependenceHighGrayLevelEmphasis (End-GLDM-LDHGLE) were independently associated with CPR. SUVpeak and SULpeak performed better than SUVmax and SULmax for MPR prediction. No significant correlation, neither between the radiologic response and the pathological response, nor among PD-L1, driver gene status, and baseline PET features was found. Inflammatory response biomarkers by peripheral blood showed no difference in different treatment responses.
The logistic regression model using comprehensive PET features contributed to predicting the pathological response after neoadjuvant toripalimab with chemotherapy in resectable stage III NSCLC patients.
摘要：
建立全面的PET影像组学模型，以预测可切除的III期非小细胞肺癌（NSCLC）患者新辅助托里帕利单抗化疗后的病理反应。
纳入接受三周期托里帕利马新辅助化疗并接受18F-FDGPET/CT的III期NSCLC患者。治疗前进行基线18F-FDGPET/CT,术前18F-FDGPET/CT在新辅助治疗完成后3周进行。新辅助治疗完成后4-5周进行手术切除。从基线和术前PET图像得出标准化摄取值（SUV）统计特征和影像组学特征。得出了Delta特征。通过iRECIST和iPERCIST评估放射学反应和代谢反应，分别。PD-L1表达之间的相关性，驱动基因状态，外周血生物标志物，并评估病理反应（完全病理反应[CPR]；主要病理反应[MPR]）。通过逻辑回归评估PET特征与病理反应之间的关联。
30例患者接受了手术，其中29例进行了术前PET/CT检查。20例患者实现了MPR，其中16例实现了CPR。在单变量分析中，5个SUV统计学特征和2个影像组学特征与病理反应显著相关.在多变量分析中，SUVmax,SUVpeak,舒尔普,和End-PET-GLDM-LargeDependenceHighGrayLevel重点(End-GLDM-LDHGLE)与CPR独立相关。对于MPR预测，SUVpeak和SULpeak的性能优于SUVmax和SULmax。没有显著的相关性，放射学反应和病理学反应都没有，在PD-L1中，驱动基因状态，和基线PET特征被发现。外周血的炎症反应生物标志物在不同的治疗反应中没有差异。
使用综合PET特征的logistic回归模型有助于预测可切除的III期NSCLC患者在托里帕利单抗新辅助化疗后的病理反应。
纳入接受三周期托里帕利马新辅助化疗并接受18F-FDGPET/CT的III期NSCLC患者。治疗前进行基线18F-FDGPET/CT,术前18F-FDGPET/CT在新辅助治疗完成后3周进行。新辅助治疗完成后4-5周进行手术切除。从基线和术前PET图像得出标准化摄取值（SUV）统计特征和影像组学特征。得出了Delta特征。通过iRECIST和iPERCIST评估放射学反应和代谢反应，分别。PD-L1表达之间的相关性，驱动基因状态，外周血生物标志物，并评估病理反应（完全病理反应[CPR]；主要病理反应[MPR]）。通过逻辑回归评估PET特征与病理反应之间的关联。
30例患者接受了手术，其中29例进行了术前PET/CT检查。20例患者实现了MPR，其中16例实现了CPR。在单变量分析中，5个SUV统计学特征和2个影像组学特征与病理反应显著相关.在多变量分析中，SUVmax,SUVpeak,舒尔普,和End-PET-GLDM-LargeDependenceHighGrayLevel重点(End-GLDM-LDHGLE)与CPR独立相关。对于MPR预测，SUVpeak和SULpeak的性能优于SUVmax和SULmax。没有显著的相关性，放射学反应和病理学反应都没有，在PD-L1中，驱动基因状态，和基线PET特征被发现。外周血的炎症反应生物标志物在不同的治疗反应中没有差异。
使用综合PET特征的logistic回归模型有助于预测可切除的III期NSCLC患者在托里帕利单抗新辅助化疗后的病理反应。
