Association between CT-texture-derived tumor heterogeneity, outcomes, and BRCA mutation status in patients with high-grade serous ovarian cancer.
Abdom Radiol (NY). 2018 Nov 24. doi: 10.1007/s00261-018-1840-5. [Epub ahead of print]
Meier A1,2, Veeraraghavan H3, Nougaret S4,5,6, Lakhman Y4, Sosa R4, Soslow RA7, Sutton EJ4, Hricak H4, Sala E4,8, Vargas HA4.
PURPOSE: To assess the associations between inter-site texture heterogeneity parameters derived from computed tomography (CT), survival, and BRCA mutation status in women with high-grade serous ovarian cancer (HGSOC).
MATERIALS AND METHODS: Retrospective study of 88 HGSOC patients undergoing CT and BRCA mutation status testing prior to primary cytoreductive surgery. Associations between texture metrics-namely inter-site cluster variance (SCV), inter-site cluster prominence (SCP), inter-site cluster entropy (SE)-and overall survival (OS), progression-free survival (PFS) as well as BRCA mutation status were assessed.
RESULTS: Higher inter-site cluster variance (SCV) was associated with lower PFS (p = 0.006) and OS (p = 0.003). Higher inter-site cluster prominence (SCP) was associated with lower PFS (p = 0.02) and higher inter-site cluster entropy (SE) correlated with lower OS (p = 0.01). Higher values of all three metrics were significantly associated with lower complete surgical resection status in BRCA-negative patients (SE p = 0.039, SCV p = 0.006, SCP p = 0.02), but not in BRCA-positive patients (SE p = 0.7, SCV p = 0.91, SCP p = 0.67). None of the metrics were able to distinguish between BRCA mutation carrier and non-mutation carrier.
CONCLUSION: The assessment of tumoral heterogeneity in the era of personalized medicine is important, as increased heterogeneity has been associated with distinct genomic abnormalities and worse patient outcomes. A radiomics approach using standard-of-care CT scans might have a clinical impact by offering a non-invasive tool to predict outcome and therefore improving treatment effectiveness. However, it was not able to assess BRCA mutation status in women with HGSOC.
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