Characterization of cervical lymph-nodes using a multi-parametric and multi-modal approach for an early prediction of tumor response to chemo-radiotherapy

Elisa Scalco, Simona Marzi, Giuseppe Sanguineti, Antonello Vidiri, Giovanna Rizzo

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). Methods: 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6. months, 19 LNs showed regional control, while 11 LNs showed. regional failure at a median time of 4.6. months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Results: Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80%); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy = 82.8%). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8%). Conclusion: Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT.

Original languageEnglish
JournalPhysica Medica
DOIs
Publication statusAccepted/In press - Jun 13 2016

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lymphatic system
radiation therapy
Radiotherapy
tumors
Lymph Nodes
diffusion coefficient
predictions
Neoplasms
textures
cancer
Diffusion Magnetic Resonance Imaging
Discriminant Analysis
pretreatment
planning
Therapeutics
examination

Keywords

  • DW-MRI
  • Head-and-neck lymph-nodes
  • T2w-MRI
  • Texture analysis

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Physics and Astronomy(all)

Cite this

@article{e0f254d51f6b4efa8550bbb11e9ce5b0,
title = "Characterization of cervical lymph-nodes using a multi-parametric and multi-modal approach for an early prediction of tumor response to chemo-radiotherapy",
abstract = "Purpose: In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). Methods: 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6. months, 19 LNs showed regional control, while 11 LNs showed. regional failure at a median time of 4.6. months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Results: Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80{\%}); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy = 82.8{\%}). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8{\%}). Conclusion: Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT.",
keywords = "DW-MRI, Head-and-neck lymph-nodes, T2w-MRI, Texture analysis",
author = "Elisa Scalco and Simona Marzi and Giuseppe Sanguineti and Antonello Vidiri and Giovanna Rizzo",
year = "2016",
month = "6",
day = "13",
doi = "10.1016/j.ejmp.2016.09.003",
language = "English",
journal = "Physica Medica",
issn = "1120-1797",
publisher = "Associazione Italiana di Fisica Medica",

}

TY - JOUR

T1 - Characterization of cervical lymph-nodes using a multi-parametric and multi-modal approach for an early prediction of tumor response to chemo-radiotherapy

AU - Scalco, Elisa

AU - Marzi, Simona

AU - Sanguineti, Giuseppe

AU - Vidiri, Antonello

AU - Rizzo, Giovanna

PY - 2016/6/13

Y1 - 2016/6/13

N2 - Purpose: In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). Methods: 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6. months, 19 LNs showed regional control, while 11 LNs showed. regional failure at a median time of 4.6. months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Results: Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80%); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy = 82.8%). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8%). Conclusion: Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT.

AB - Purpose: In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). Methods: 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6. months, 19 LNs showed regional control, while 11 LNs showed. regional failure at a median time of 4.6. months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Results: Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80%); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy = 82.8%). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8%). Conclusion: Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT.

KW - DW-MRI

KW - Head-and-neck lymph-nodes

KW - T2w-MRI

KW - Texture analysis

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JF - Physica Medica

SN - 1120-1797

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