Purpose: To evaluate changes in texture analysis parameters of CT images after adjuvant stereotactic body radiation therapy (SBRT) in patients with locally advanced pancreatic adenocarcinoma. Material and methods: Pre- and post-SBRT contrast-enhanced CT examinations of 54 patients with locally advanced pancreatic adenocarcinoma were retrospectively evaluated. 3D regions of interest were manually drawn on arterial- and portal-phase CT images to comprise the whole tumor; 47 texture parameters were analyzed. Baseline and post-SBRT tumor volumes and texture parameters were compared between groups (resected versus non-resected and R0 versus R1-2 resection) using Wilcoxon test. Results: Forty patients (72.7%) underwent surgical resection after SBRT; among them, 25 had R0 resection (62.5%). Baseline tumor volume was not significantly different between groups (p>.05). Resected and R0 patients had significant tumor volume change after SBRT compared to non-resected and R1/2 patients (-39.7% vs +22.6%, p=.005; and -47.1% vs -17.3%, p=.017). Texture analysis identified 31 arterial-phase parameters and 27 portal-phase parameters significantly different before and after SBRT in resected tumors (p<.05). Among resected tumors, 22 arterial-phase parameters and 28 portal-phase parameters were significantly different after SBRT compared to baseline (p<.05). Conclusion: Texture analysis of contrast-enhanced CT images can identify changes after SBRT in locally advanced tumors that could be predictive of resectability and R0 resection.

Can CT texture analysis predict resectability and surgical outcomes after neoadjuvant radiotherapy in pancreatic cancer patients?

R. De Robertis;N. Cardobi;S. Paiella;R. Mazzarotto;S. Montemezzi;D’Onofrio
2020

Abstract

Purpose: To evaluate changes in texture analysis parameters of CT images after adjuvant stereotactic body radiation therapy (SBRT) in patients with locally advanced pancreatic adenocarcinoma. Material and methods: Pre- and post-SBRT contrast-enhanced CT examinations of 54 patients with locally advanced pancreatic adenocarcinoma were retrospectively evaluated. 3D regions of interest were manually drawn on arterial- and portal-phase CT images to comprise the whole tumor; 47 texture parameters were analyzed. Baseline and post-SBRT tumor volumes and texture parameters were compared between groups (resected versus non-resected and R0 versus R1-2 resection) using Wilcoxon test. Results: Forty patients (72.7%) underwent surgical resection after SBRT; among them, 25 had R0 resection (62.5%). Baseline tumor volume was not significantly different between groups (p>.05). Resected and R0 patients had significant tumor volume change after SBRT compared to non-resected and R1/2 patients (-39.7% vs +22.6%, p=.005; and -47.1% vs -17.3%, p=.017). Texture analysis identified 31 arterial-phase parameters and 27 portal-phase parameters significantly different before and after SBRT in resected tumors (p<.05). Among resected tumors, 22 arterial-phase parameters and 28 portal-phase parameters were significantly different after SBRT compared to baseline (p<.05). Conclusion: Texture analysis of contrast-enhanced CT images can identify changes after SBRT in locally advanced tumors that could be predictive of resectability and R0 resection.
imaging
pancreas
texture analysis
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1022347
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