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Hermans BCM, Sanduleanu S, Derks JL, Woodruff H, Hillen LM, Casale R, Hoesein FM, de Jong E, Berge DMHJT, Speel EJM, Lambin P, Gietema HA, Dingemans AMC. Exploring imaging features of molecular subtypes of large cell neuroendocrine carcinoma (LCNEC). Lung Cancer 2020; 148:94-99. [PMID: 32858338 DOI: 10.1016/j.lungcan.2020.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Radiological characteristics and radiomics signatures can aid in differentiation between small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC). We investigated whether molecular subtypes of large cell neuroendocrine carcinoma (LCNEC), i.e. SCLC-like (with pRb loss) vs. NSCLC-like (with pRb expression), can be distinguished by imaging based on (1) imaging interpretation, (2) semantic features, and/or (3) a radiomics signature, designed to differentiate between SCLC and NSCLC. MATERIALS AND METHODS Pulmonary oncologists and chest radiologists assessed chest CT-scans of 44 LCNEC patients for 'small cell-like' or 'non-small cell-like' appearance. The radiologists also scored semantic features of 50 LCNEC scans. Finally, a radiomics signature was trained on a dataset containing 48 SCLC and 76 NSCLC scans and validated on an external set of 58 SCLC and 40 NSCLC scans. This signature was applied on scans of 28 SCLC-like and 8 NSCLC-like LCNEC patients. RESULTS Pulmonary oncologists and radiologists were unable to differentiate between molecular subtypes of LCNEC and no significant differences in semantic features were found. The area under the receiver operating characteristics curve of the radiomics signature in the validation set (SCLC vs. NSCLC) was 0.84 (95% confidence interval (CI) 0.77-0.92) and 0.58 (95% CI 0.29-0.86) in the LCNEC dataset (SCLC-like vs. NSCLC-like). CONCLUSION LCNEC appears to have radiological characteristics of both SCLC and NSCLC, irrespective of pRb loss, compatible with the SCLC-like subtype. Imaging interpretation, semantic features and our radiomics signature designed to differentiate between SCLC and NSCLC were unable to separate molecular LCNEC subtypes, which underscores that LCNEC is a unique disease.
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Affiliation(s)
- B C M Hermans
- Department of Pulmonary Diseases, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - S Sanduleanu
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; The D-Lab, Department of Precision Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - J L Derks
- Department of Pulmonary Diseases, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - H Woodruff
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands; The D-Lab, Department of Precision Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - L M Hillen
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Pathology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - R Casale
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; The D-Lab, Department of Precision Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - F Mohamed Hoesein
- Department of Radiology, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands
| | - E de Jong
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; The D-Lab, Department of Precision Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - D M H J Ten Berge
- Department of Radiology, Erasmus Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Pulmonology, Erasmus Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - E J M Speel
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Pathology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - P Lambin
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands; The D-Lab, Department of Precision Medicine, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - H A Gietema
- GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - A-M C Dingemans
- Department of Pulmonary Diseases, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands; GROW - School for Oncology & Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Pulmonology, Erasmus Medical Centre, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
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