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. 2023 Feb 9;15(4):1105.
doi: 10.3390/cancers15041105.

Association of Multi-Phasic MR-Based Radiomic and Dosimetric Features with Treatment Response in Unresectable Hepatocellular Carcinoma Patients following Novel Sequential TACE-SBRT-Immunotherapy

Lok-Man Ho  1   2 , Sai-Kit Lam  3   4 , Jiang Zhang  5 , Chi-Leung Chiang  6 , Albert Chi-Yan Chan  7 , Jing Cai  3   5
Affiliations

Association of Multi-Phasic MR-Based Radiomic and Dosimetric Features with Treatment Response in Unresectable Hepatocellular Carcinoma Patients following Novel Sequential TACE-SBRT-Immunotherapy

Lok-Man Ho et al. Cancers (Basel). .

Abstract

This study aims to investigate the association of pre-treatment multi-phasic MR-based radiomics and dosimetric features with treatment response to a novel sequential trans-arterial chemoembolization (TACE) plus stereotactic body radiotherapy (SBRT) plus immunotherapy regimen in unresectable Hepatocellular Carcinoma (HCC) sub-population. Twenty-six patients with unresectable HCC were retrospectively analyzed. Radiomic features were extracted from 42 lesions on arterial phase (AP) and portal-venous phase (PVP) MR images. Delta-phase (DeltaP) radiomic features were calculated as AP-to-PVP ratio. Dosimetric data of the tumor was extracted from dose-volume-histograms. A two-sided independent Mann-Whitney U test was used to assess the clinical association of each feature, and the classification performance of each significant independent feature was assessed using logistic regression. For the 3-month timepoint, four DeltaP-derived radiomics that characterize the temporal change in intratumoral randomness and uniformity were the only contributors to the treatment response association (p-value = 0.038-0.063, AUC = 0.690-0.766). For the 6-month timepoint, DeltaP-derived radiomic features (n = 4) maintained strong clinical associations with the treatment response (p-value = 0.047-0.070, AUC = 0.699-0.788), additional AP-derived radiomic features (n = 4) that reflect baseline tumoral arterial-enhanced signal pattern and tumor morphology (n = 1) that denotes initial tumor burden were shown to have strong associations with treatment response (p-value = 0.028-0.074, AUC = 0.719-0.773). This pilot study successfully demonstrated associations of pre-treatment multi-phasic MR-based radiomics with tumor response to the novel treatment regimen.

Keywords: hepatocellular carcinoma; immunotherapy; magnetic resonance imaging; radiomics; stereotactic body radiotherapy; trans-arterial chemoembolization.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A 76-year-old male patient was diagnosed with advanced-staged HCC. (a) Axial AP T1W MR image with the VOI, (b) Axial PVP T1W MR image with the VOI. SBRT of 30 Gy was prescribed in 5 fractions to the tumor. (c) DVH of gross tumor volume (GTV) and planning target volume (PTV) generated from the treatment planning system and (d) Dose distribution of the SBRT treatment plan.
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