Original Research ARTICLE
Machine Learning-Based Radiomics Predicts Radiotherapeutic Response in Patients with Acromegaly
- 1Department of Neurosurgery, Peking Union Medical College Hospital (CAMS), China
- 2East China Jiaotong University, China
Background: Prediction of radiotherapeutic response before radiotherapy could help determine individual treatment strategies for patients with acromegaly.
Objective: To develop and validate a machine-learning-based multiparametric MRI radiomics model to non-invasively predict radiotherapeutic response in patients with acromegaly.
Methods: This retrospective study included 57 acromegaly patients who underwent postoperative radiotherapy between January 2008 and January 2016. Manual lesion segmentation and radiomics analysis were performed on each pituitary adenoma, and 1561 radiomics features were extracted from each sequence. A radiomics signature was built with a support vector machine using leave-one-out cross-validation for feature selection. Multivariable logistic regression analysis was used to select appropriate clinicopathological features to construct a clinical model, which was then combined with the radiomics signature to construct a radiomics model. The performance of this radiomic model was assessed using receiver operating characteristics (ROC) analysis and its calibration, discriminating ability, clinical usefulness.
Results: At 3-years after radiotherapy, 25 patients had achieved remission and 32 patients had not. The clinical model incorporating seven clinical features had an area under the ROC (AUC) of 0.86 for predicting radiotherapeutic response, and performed better than any single clinical feature. The radiomics signature constructed with six radiomics features had a significantly higher AUC of 0.92. The radiomics model showed good discrimination abilities and calibration, with an AUC of 0.96. Decision curve analysis confirmed the clinical utility of the radiomics model.
Conclusion: Using pre-radiotherapy clinical and MRI data, we developed a radiomics model with favorable performance for individualized non-invasive prediction of radiotherapeutic response, which may help in identifying acromegaly patients who are likely to benefit from radiotherapy.
Keywords: Acromegaly, Radiomics, radiotherapeutic response, Magnetic Resonance Imaging, Receiver Operating Characteristics (ROC)
Received: 12 Jun 2019;
Accepted: 12 Aug 2019.
Copyright: © 2019 Fan, Jiang, Hua, Feng, Bao, Wang and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Ming Feng, Department of Neurosurgery, Peking Union Medical College Hospital (CAMS), Beijing, 100032, China, firstname.lastname@example.org