Correlation of CT texture changes with treatment response during radiation therapy for esophageal cancer: An exploratory study

• Published in: PloS one 2019-09, Vol.14 (9), p.e0223140-e0223140
• Main Authors: Yan, Zhumin, Zhang, Jingqiao, Long, Hai, Sun, Xueming, Li, Dingjie, Tang, Tian, Li, X Allen, Hui, Wu
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bioindicators; Biology and Life Sciences; Biomarkers; Cancer; Cancer therapies; Chemoradiotherapy - methods; Cisplatin - therapeutic use; Coarseness; Computed tomography; Correlation; Correlation analysis; Dose Fractionation, Radiation; Endoscopy; Entropy; Esophageal cancer; Esophageal Mucosa - diagnostic imaging; Esophageal Mucosa - pathology; Esophageal Mucosa - radiation effects; Esophageal Neoplasms - diagnostic imaging; Esophageal Neoplasms - mortality; Esophageal Neoplasms - therapy; Esophageal Squamous Cell Carcinoma - diagnostic imaging; Esophageal Squamous Cell Carcinoma - pathology; Esophageal Squamous Cell Carcinoma - therapy; Esophagectomy; Esophagus; Feature extraction; Female; Follow-Up Studies; Head & neck cancer; Humans; Lung cancer; Male; Medical prognosis; Medicine and Health Sciences; Middle Aged; Mucosa; Neoadjuvant Therapy - methods; Oncology; Pancreatic cancer; Patients; Physical Sciences; Prognosis; Radiation; Radiation Dosage; Radiation therapy; Radiotherapy, Image-Guided - methods; Research and Analysis Methods; Spinal cord; Squamous cell carcinoma; Strength; Survival; Survival Rate; Systematic review; Texture; Time Factors; Tomography; Tomography, X-Ray Computed; Treatment Outcome; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0223140

To analyze the change of CT texture features of esophageal squamous cell carcinoma (ESC) during RT delivery and to correlate these changes with the RT responses and survival. A total of 61 ESC patients received radical RT were screened. Weekly CTs (4-6 sets for each patient) were acquired during RT. The tumors, normal esophageal mucosa tissue (NEC) of 5 cm and the spinal cord in the relevant area were delineated. CT texture features were extracted with a home-made tool. The changes of these features were analyzed by t-test. The correlations of the changes of features with RT responses and with patient survival were investigated by Pearson analysis. The average changes were increased by 0.00072 ±0.00197 for coarseness, by 0.14 ±0.40 for entropy, and by 2.34 ±3.56 for strength. In addition, the average changes were reduced by 8.88 ±15.71cc for volume and by 0.07 ±0.11 for busyness. The changes of the coarseness, strength, STD and entropy in ESC were different for the good and poor response groups. The survival rate of the patients was significantly correlated with the change of coarseness and strength (P = 0.0027 and P = 0.0001). During RT, changes of CT texture features of ESC, e.g., coarseness, strength, STD, entropy and volume are correlated with radiation response and survival rate. With more clinical data and robust research, CT features, e.g., coarseness and strength, can be selected as outstanding imaging biomarkers for prediction of RT prognosis of ESC.