To construct and validate a combined model based on axial skeleton radiomics of 18F-FDG PET/CT for predicting event-free survival in high-risk pediatric neuroblastoma patients.
Materials and Methods
Eighty-seven high-risk neuroblastoma patients were retrospectively enrolled in this study and randomized in a 7:3 ratio to the training and validation cohorts. The radiomics model was constructed using radiomics features that were extracted from the axial skeleton. A univariate Cox regression analysis was then performed to screen clinical risk factors associated with event-free survival for building clinical model. Radiomics features and clinical risk factors were incorporated to construct the combined model for predicting the event-free survival in high-risk neuroblastoma patients. The performance of the models was evaluated by the C-index.
Eighteen radiomics features were selected to build the radiomics model. The radiomics model achieved better event-free survival prediction than the clinical model in the training cohort (C-index: 0.846 vs. 0.612) and validation cohort (C-index: 0.754 vs. 0.579). The combined model achieved the best prognostic prediction performance with a C-index of 0.863 and 0.799 in the training and validation cohorts, respectively.
The combined model integrating radiomics features and clinical risk factors showed more accurate predictive performance for event-free survival in high-risk pediatric neuroblastoma patients, which helps to design individualized treatment strategies and regular follow-ups.
Abbreviations:AUC (area under the curve), CI (confidence interval), HVA (homovanillic acid), ICC (intraclass correlation coefficient), INRG (International Neuroblastoma Risk Group), LASSO (least absolute shrinkage and selection operator), ROC (receiver operating characteristic), ROIs (regions of interest), VMA (vanillylmandelic acid)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Academic Radiology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Clinical parameters combined with radiomics features of PET/CT can predict recurrence in patients with high-risk pediatric neuroblastoma.BMC Med Imaging. 2022; 22: 102
- An 18F-FDG PET/CT radiomics nomogram for differentiation of high-risk and non-high-risk patients of the International Neuroblastoma Risk Group Staging System.Eur J Radiol. 2022; 154110444
- The International Neuroblastoma Risk Group (INRG) classification system: an INRG Task Force report.J Clin Oncol. 2009; 27: 289-297
- Non-High-Risk Neuroblastoma: classification and achievements in therapy.Children (Basel). 2019; 6https://doi.org/10.3390/children6010005
- Recent advances in neuroblastoma.N Engl J Med. 2010; 362: 2202-2211
- A nomogram for predicting recurrence-free survival of intermediate and high-risk neuroblastoma.Eur J Pediatr. 2022; 181: 4135-4147
- Prediction to the prognosis of children with neuroblastoma by nomogram based on the first-diagnosed inflammatory markers.Pediatr Surg Int. 2022; 39: 17
- A prognostic nomogram for neuroblastoma in children.PeerJ. 2019; 7: e7316
- Association of image-defined risk factors with clinical features, histopathology, and outcomes in neuroblastoma.Cancer Med. 2021; 10: 2232-2241
- Interpretation of radiomics features: a pictorial review.Comput Methods Programs Biomed. 2022; 215106609
- 18F-FDG PET/CT-based radiomics nomogram could predict bone marrow involvement in pediatric neuroblastoma.Insights Imaging. 2022; 13: 144
- Role of radiomics-based baseline PET/CT imaging in lymphoma: diagnosis, prognosis, and response assessment.Mol Imaging Biol. 2022; 24: 537-549
- Recommendations for the standardization of bone marrow disease assessment and reporting in children with neuroblastoma on behalf of the International Neuroblastoma Response Criteria Bone Marrow Working Group.Cancer. 2017; 123: 1095-1105
- The diagnostic value of 18F-FDG PET/CT bone marrow uptake pattern in detecting bone marrow involvement in pediatric neuroblastoma patients.Contrast Media Mol Imaging. 2022; 20227556315
- Diagnostic value of 18F-FDG PET/CT-based radiomics nomogram in bone marrow involvement of pediatric neuroblastoma.Acad Radiol. 2022; https://doi.org/10.1016/j.acra.2022.08.021
- Computed Tomography-based radiomics nomogram for predicting the postoperative prognosis of esophageal squamous cell carcinoma: a multicenter study.Acad Radiol. 2022; https://doi.org/10.1016/j.acra.2022.01.020
- Bone marrow and tumor radiomics at 18F-FDG PET/CT: impact on outcome prediction in non-small cell lung cancer.Radiology. 2019; 293: 451-459
- Effect of tandem autologous stem cell transplant vs single transplant on event-free survival in patients with high-risk neuroblastoma: a randomized clinical trial.JAMA. 2019; 322: 746-755
- Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology.Eur J Nucl Med Mol Imaging. 2008; 35: 1581-1588
- FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0.Eur J Nucl Med Mol Imaging. 2015; 42: 328-354
- Machine learning-based CT radiomics approach for predicting WHO/ISUP nuclear grade of clear cell renal cell carcinoma: an exploratory and comparative study.Insights Imaging. 2021; 12: 170
- Ultrasonic features and molecular subtype predict somatic mutations in TP53 and PIK3CA genes in breast cancer.Acad Radiol. 2022; 29: e261-e270
- Radiomics facilitates candidate selection for irradiation stents among patients with unresectable pancreatic cancer.Front Oncol. 2019; 9: 973
- A novel analytic approach for outcome prediction in diffuse large B-cell lymphoma by [18F]FDG PET/CT.Eur J Nucl Med Mol Imaging. 2022; 49: 1298-1310
- Sensitivity of surveillance studies for detecting asymptomatic and unsuspected relapse of high-risk neuroblastoma.J Clin Oncol. 2009; 27: 1041-1046
- Prognostic value of metabolic indices and bone marrow uptake pattern on preoperative 18F-FDG PET/CT in pediatric patients with neuroblastoma.Eur J Nucl Med Mol Imaging. 2018; 45: 306-315
- PET-CT radiomics by integrating primary tumor and peritumoral areas predicts E-cadherin expression and correlates with pelvic lymph node metastasis in early-stage cervical cancer.Eur Radiol. 2021; 31: 5967-5979
- Diagnostic and prognostic value of baseline FDG PET/CT skeletal textural features in diffuse large B cell lymphoma.Eur J Nucl Med Mol Imaging. 2018; 45: 699-711
- A nomogram of clinical and biologic factors to predict survival in children newly diagnosed with high-risk neuroblastoma: an International Neuroblastoma Risk Group project.Pediatr Blood Cancer. 2021; 68: e28794
- Evidence for an age cutoff greater than 365 days for neuroblastoma risk group stratification in the Children's Oncology Group.J Clin Oncol. 2005; 23: 6459-6465
- Detection of metastatic neuroblastoma in bone marrow: when is routine marrow histology insensitive?.J Clin Oncol. 1997; 15: 2807-2817
- Clinical significance of persistent tumor in bone marrow during treatment of high-risk neuroblastoma.J Korean Med Sci. 2015; 30: 1062-1067
- Diagnostic and prognostic impact of urinary catecholamines in neuroblastoma patients.Pediatr Blood Cancer. 2007; 48: 504-509
N Hwang, E Chong, H Oh, et al., Application of an LC-MS/MS method for the simultaneous quantification of homovanillic acid and vanillylmandelic acid for the diagnosis and follow-up of neuroblastoma in 357 patients, Molecules, 26 (11), 2021, 3470. doi:10.3390/molecules26113470.
- Tumour markers are poor predictors for relapse or progression in neuroblastoma.Eur J Cancer. 2003; 39: 1899-1903
Published online: February 22, 2023
Accepted: January 24, 2023
Received in revised form: January 24, 2023
Received: December 29, 2022
Publication stageIn Press Corrected Proof
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.