Author of

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  P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 26855

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    P2.01-56 - Metastases in Residual PET Uptake of Lymph Nodes After Treatment: Added Value of CT Radiomic Approach for Prediction (ID 12595)

    16:45 - 18:00  |  Presenting Author(s): Chu Hyun Kim
    • Abstract
    • Slides

    Background
    

    Although substantial decrease of FDG uptake on positron emission tomography-computed tomography (PET-CT) holds promise metabolic response, predicting pathologic complete response of lymph nodes still remains challenging. We investigated the potential of CT radiomics features to predict pathologic complete response of lymph nodes showing residual uptake on PET-CT after neoadjuvant concurrent chemoradiotherapy (CCRT) in stage IIIa non-small cell lung cancer (NSCLC).

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    From 2004 through 2013, all consecutive patients who underwent neoadjuvant CCRT for stage IIIa NSCLC, post-treatment PET-CT, and curative operation were included. As for all lymph nodes which showed remaining positive FDG uptake on restaging PET-CT, 161 CT Radiomic features from physical, shape, histogram, texture, regional feature categories were extracted. Positive and negative lymph node metastases were compared with respect to clinicopathologic characteristics as well as CT radiomic features using the Pearson χ2 test or the Fisher exact test Multivariate logistic regression was used to explore the predictive model for the the detection of metastatic lymph nodes, for which receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Of 237 patients undergoing neoadjuvant CCRT for stage IIIa NSCLC, 135 patients (56.9%) showed residual PET uptake on 177 lymph nodes after treatment. Among those 177 lymph nodes, 70 lymph nodes were proven to be malignant (39.5%, 70 of 177). On multivariate analysis, metastatic lymph nodes were significantly tended to be more squamous cell carcinoma than adenocarcinoma (odds ratio [OR] = 0.370, 95% confidence interval [CI] = 0.190 to 0.722; reference of adenocarcinoma, P value = 0.004) and higher entropy-GLCM (OR = 1.437, 95% CI = 1.147 to 1.802, P value = 0.002), where the predictive model for metastasis showed discrimination performance with an area under the receiver operating characteristic curve (AUC) of 0.770 (95% CI = 0.700 to 0.839, P value < 0.001).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Radiomic approach allows for noninvasive detection of lymph node metastases in lymph nodes showing residual PET uptake after treatment in NSCLC patients

    6f8b794f3246b0c1e1780bb4d4d5dc53

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