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Year : 2020  |  Volume : 11  |  Issue : 2  |  Page : 56-61

Computed tomography texture-based radiomics analysis as a predictor of response in head-and-neck cancer treated with chemoradiation and hyperthermia

Department of Advanced Centre for Radiation Oncology (ACRO), Nanavati Super Speciality Hospital, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Gopal Pemmaraju
Department of Advanced Centre for Radiation Oncology (ACRO), Nanavati Super Speciality Hospital, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jrcr.jrcr_21_20

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Aim: In this pilot retrospective study, we aim to assess the ability of computed tomography (CT) texture-based radiomics analysis to predict the response in locally advanced head-and-neck cancer patients treated with chemoradiation and hyperthermia. Materials and Methods: Patients with locally advanced head-and-neck cancer who were treated with multiple modalities of chemoradiation and hyperthermia or radiation with hyperthermia between January 2018 and December 2019 were analyzed. The initial response was scored as complete response (CR), partial response, no response, or progressive disease. CT representing central core of the tumor, and 2 cm on either pole was segmented. These segmented sections of CT scans were analyzed on TexRAD software. Results: A total of 25 patients' data were analyzed, of which 15 are males, and most of the patients had Stage III or IV disease. Eleven patients received ≥10 sittings of hyperthermia. Only those who had CR 16 patients were included as responders and the rest as nonresponders (NRs). A higher kurtosis value is associated with non responders. Receiver operating characteristics further demonstrated kurtosis at fine texture scale ≥1.29 suggested NR. A total number of pixels of the center core is a significant differentiator between CR and NR (P = 0.039). Similarly, the mean density of the top section is a significant differentiator (P = 0.044). A higher mean density is indicative of NR. A higher composite score is associated with NR. Conclusion: Texture-based radiomics analysis on CT is an inexpensive, noninvasive addition based on imaging for prognostication potentially acting as an imaging biomarker. A composite score – a new paradigm as illustrated in this article demonstrates promise in assessing the response in head-and-neck cancer patients treated with hyperthermia in addition to radiation or chemotherapy, which needs to be further confirmed in a larger, prospective study.

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