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Bernatz S, Elenberger O, Ackermann J, Lenga L, Martin SS, Scholtz JE, Koch V, Grünewald LD, Herrmann Y, Kinzler MN, Stehle A, Koch I, Zeuzem S, Bankov K, Doering C, Reis H, Flinner N, Schulze F, Wild PJ, Hammerstingl R, Eichler K, Gruber-Rouh T, Vogl TJ, dos Santos DP, Mahmoudi S. CT-radiomics and clinical risk scores for response and overall survival prognostication in TACE HCC patients. Sci Rep 2023; 13:533. [PMID: 36631548 PMCID: PMC9834236 DOI: 10.1038/s41598-023-27714-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
We aimed to identify hepatocellular carcinoma (HCC) patients who will respond to repetitive transarterial chemoembolization (TACE) to improve the treatment algorithm. Retrospectively, 61 patients (mean age, 65.3 years ± 10.0 [SD]; 49 men) with 94 HCC mRECIST target-lesions who had three consecutive TACE between 01/2012 and 01/2020 were included. Robust and non-redundant radiomics features were extracted from the 24 h post-embolization CT. Five different clinical TACE-scores were assessed. Seven different feature selection methods and machine learning models were used. Radiomics, clinical and combined models were built to predict response to TACE on a lesion-wise and patient-wise level as well as its impact on overall-survival prognostication. 29 target-lesions of 19 patients were evaluated in the test set. Response rates were 37.9% (11/29) on the lesion-level and 42.1% (8/19) on the patient-level. Radiomics top lesion-wise response prognostications was AUC 0.55-0.67. Clinical scores revealed top AUCs of 0.65-0.69. The best working model combined the radiomic feature LargeDependenceHighGrayLevelEmphasis and the clinical score mHAP_II_score_group with AUC = 0.70, accuracy = 0.72. We transferred this model on a patient-level to achieve AUC = 0.62, CI = 0.41-0.83. The two radiomics-clinical features revealed overall-survival prognostication of C-index = 0.67. In conclusion, a random forest model using the radiomic feature LargeDependenceHighGrayLevelEmphasis and the clinical mHAP-II-score-group seems promising for TACE response prognostication.
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Affiliation(s)
- Simon Bernatz
- University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany. .,Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590, Frankfurt am Main, Germany. .,Frankfurt Cancer Institute (FCI), 60590, Frankfurt am Main, Germany.
| | - Oleg Elenberger
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Jörg Ackermann
- grid.7839.50000 0004 1936 9721Department of Molecular Bioinformatics, Institute of Computer Science, Goethe University Frankfurt am Main, Robert-Mayer-Str. 11-15, 60325 Frankfurt am Main, Germany
| | - Lukas Lenga
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Simon S. Martin
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Jan-Erik Scholtz
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Vitali Koch
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Leon D. Grünewald
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Yannis Herrmann
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Maximilian N. Kinzler
- grid.411088.40000 0004 0578 8220Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Angelika Stehle
- grid.411088.40000 0004 0578 8220Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Ina Koch
- grid.7839.50000 0004 1936 9721Department of Molecular Bioinformatics, Institute of Computer Science, Goethe University Frankfurt am Main, Robert-Mayer-Str. 11-15, 60325 Frankfurt am Main, Germany
| | - Stefan Zeuzem
- grid.411088.40000 0004 0578 8220Department of Internal Medicine I, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Katrin Bankov
- grid.7839.50000 0004 1936 9721Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt am Main, Germany
| | - Claudia Doering
- grid.7839.50000 0004 1936 9721Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt am Main, Germany
| | - Henning Reis
- grid.7839.50000 0004 1936 9721Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt am Main, Germany
| | - Nadine Flinner
- grid.7839.50000 0004 1936 9721Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt am Main, Germany
| | - Falko Schulze
- grid.7839.50000 0004 1936 9721Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt am Main, Germany
| | - Peter J. Wild
- grid.7839.50000 0004 1936 9721Dr. Senckenberg Institute for Pathology, University Hospital Frankfurt, Goethe University Frankfurt am Main, 60590 Frankfurt am Main, Germany ,grid.511198.5Frankfurt Cancer Institute (FCI), 60590 Frankfurt am Main, Germany ,grid.417999.b0000 0000 9260 4223Frankfurt Institute for Advanced Studies (FIAS), 60438 Frankfurt am Main, Germany
| | - Renate Hammerstingl
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Katrin Eichler
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Tatjana Gruber-Rouh
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Thomas J. Vogl
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Daniel Pinto dos Santos
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany ,grid.6190.e0000 0000 8580 3777Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Scherwin Mahmoudi
- grid.7839.50000 0004 1936 9721University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology, Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
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