Dynamic thermography has been widely used as a diagnostic tool in breast cancer screening before mammography and with clinical breast examination (CBE). Thermal imaging biomarkers, thermomics, are proven to highlight the heterogeneous thermal patterns and vasodilation indicating abnormalities in the area due to angiogenesis blood vessel formation. This study shows two sets of analyses. The first set is a feasibility study involving a combined multimodal imaging biomarker using mammographic and thermographic imaging for 11 cases of breast cancer screening. The second part of this paper shows the application of the t-distributed stochastic neighbor embedding (tSNE) method to provide a low dimensional representation of thermal sequence and tested for 55 breast cancer screening participants. We extracted high dimensional radiomics and thermomics and reduced the dimensionality of these features using spectral embedding technique, and trained a random forest model with tuned hyperparameters to perform diagnostic prediction. The results of tSNE combining clinical and demographics yield 77.4% (69.8%, 86.8%), while the highest accuracy belonged to Sparse PCT + Clinical with 79.3% (73.6%, 84.9%). The proposed method results indicated that the tSNE can preserve thermal patterns driven radiothermomics, which leads to significantly aid in CBE and early detection of breast cancer.
We compare techniques for addressing heterogeneity in image physical dimensions and acquisition parameters, and how these methods affect the predictive performance of radiomic features. We further combine radiomic signatures with established clinical prognostic factors to predict progression-free survival (PFS) in stage four NSCLC patients undergoing first-line immunotherapy. Our study includes 124 stage 4 NSCLC patients treated with pembrolizumab (monotherapy:30.65%, combination therapy:69.35%). The Captk software was used to extract radiomic features (n=102) from 3D tumor volumes segmented from lung CT scans with ITK-SNAP. The ability of the following approaches to mitigate the heterogeneity in image physical dimensions (voxel spacing parameters) and acquisition parameters (contrast enhancement and CT reconstruction kernel) were evaluated: resampling the images (to minimum/maximum voxel spacing parameters), harmonization of radiomic features using a nested ComBat technique (taking voxel spacing and/or image acquisition parameters as batch variables) or a combination of resampling the images to the minimum voxel spacing parameters and applying nested harmonization by image acquisition parameters. Two radiomic phenotypes were identified using unsupervised hierarchical clustering of the extracted radiomic features derived from each of these scenarios. Established prognostic factors, including PDL1 expression, ECOG status, BMI and smoking status, were combined with radiomic phenotypes in five-fold cross-validated multivariate Cox proportional hazards models (200 iterations) of progression-free survival. A Cox model based only on clinical factors had a cstatistic (mean, 95% CI) of 0.53[0.50,0.57], which increased to 0.62[0.55,0.64] upon the addition of radiomic phenotypes derived from images which had been resampled to minimum voxel spacing and harmonized by image acquisition parameters. In addition to the cross-validated cstatistics, we also built a model on the complete dataset of features corresponding to each of the approaches to evaluate the Kaplan Meier performance in separating patients above versus below the median prognostic score. This preliminary study aims to draw comparisons between the various techniques used to address the issue of reproducibility in radiomic features derived from medical images with heterogeneous parameters.
Prognosis plays a crucial role in the customization of lung cancer care. The effective prediction of treatment response is essential to tailor treatment decisions to lung cancer patients. Molecular characterization of tumors using genomics-based approaches is important for personalized treatment planning, however, repeated tumor biopsies should be performed to capture their molecular heterogeneity, putting patients at risk of procedural complications such as a pneumothorax. Furthermore, the recent addition of immunotherapy after chemoradiotherapy for patients with unresectable stage III NSCLC can improve survival outcomes. The survival benefit achieved by stage III NSCLC patients undergoing chemoradiation is of interest since currently available biomarkers are inadequate to predict which patients are most likely to benefit from immunotherapy for first-line treatment along with chemoradiation. In this study, we investigate the association between local failure-free survival and radiomic features extracted from CT scans of stage III NSCLC adenocarcinoma patients. We retrospectively analyzed a well-curated cohort of 89 non-contrast enhanced CT scans from patients receiving homogeneous chemoradiation treatment. A set of 107 radiomic features was extracted using the pyradiomics package. In univariate analysis we performed log-rank tests per feature to predict risk of local failure. In multivariate analysis we applied principal component analysis to fit a Cox model to predict local failure-free survival. Univariate analysis showed that no individual radiomic feature can predict local failure-free survival, while multivariate analysis gave a C-index = 0.70, 95% CI = [0.56,0.85]. We conclude that radiomic features from CT scans, can predict local failure-free survival in stage III NSCLC.
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