Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy
BACKGROUND: Surgical resection is the standard of care for patients with large or symptomatic brain metastases (BMs). Despite improved local control after adjuvant stereotactic radiotherapy, the risk of local failure (LF) persists. Therefore, we aimed to develop and externally validate a pre-therape...
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
30 May 2024
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| In: |
Neuro-Oncology
Year: 2024, Jahrgang: 26, Heft: 9, Pages: 1638-1650 |
| ISSN: | 1523-5866 |
| DOI: | 10.1093/neuonc/noae098 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1093/neuonc/noae098 Resolving-System, kostenfrei: https://dx.doi.org/10.1093/neuonc/noae098 
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| Verfasserangaben: | Josef A. Buchner, Florian Kofler, Michael Mayinger, Sebastian M. Christ, Thomas B. Brunner, Andrea Wittig, Bjoern Menze, Claus Zimmer, Bernhard Meyer, Matthias Guckenberger, Nicolaus Andratschke, Rami A. El Shafie, Jürgen Debus, Susanne Rogers, Oliver Riesterer, Katrin Schulze, Horst J. Feldmann, Oliver Blanck, Constantinos Zamboglou, Konstantinos Ferentinos, Angelika Bilger-Zähringer, Anca L. Grosu, Robert Wolff, Marie Piraud, Kerstin A. Eitz, Stephanie E. Combs, Denise Bernhardt, Daniel Rueckert, Benedikt Wiestler, and Jan C. Peeken |
MARC
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| 245 | 1 | 0 | |a Radiomics-based prediction of local control in patients with brain metastases following postoperative stereotactic radiotherapy |c Josef A. Buchner, Florian Kofler, Michael Mayinger, Sebastian M. Christ, Thomas B. Brunner, Andrea Wittig, Bjoern Menze, Claus Zimmer, Bernhard Meyer, Matthias Guckenberger, Nicolaus Andratschke, Rami A. El Shafie, Jürgen Debus, Susanne Rogers, Oliver Riesterer, Katrin Schulze, Horst J. Feldmann, Oliver Blanck, Constantinos Zamboglou, Konstantinos Ferentinos, Angelika Bilger-Zähringer, Anca L. Grosu, Robert Wolff, Marie Piraud, Kerstin A. Eitz, Stephanie E. Combs, Denise Bernhardt, Daniel Rueckert, Benedikt Wiestler, and Jan C. Peeken |
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| 520 | |a BACKGROUND: Surgical resection is the standard of care for patients with large or symptomatic brain metastases (BMs). Despite improved local control after adjuvant stereotactic radiotherapy, the risk of local failure (LF) persists. Therefore, we aimed to develop and externally validate a pre-therapeutic radiomics-based prediction tool to identify patients at high LF risk. - METHODS: Data were collected from A Multicenter Analysis of Stereotactic Radiotherapy to the Resection Cavity of BMs (AURORA) retrospective study (training cohort: 253 patients from 2 centers; external test cohort: 99 patients from 5 centers). Radiomic features were extracted from the contrast-enhancing BM (T1-CE MRI sequence) and the surrounding edema (T2-FLAIR sequence). Different combinations of radiomic and clinical features were compared. The final models were trained on the entire training cohort with the best parameter set previously determined by internal 5-fold cross-validation and tested on the external test set. - RESULTS: The best performance in the external test was achieved by an elastic net regression model trained with a combination of radiomic and clinical features with a concordance index (CI) of 0.77, outperforming any clinical model (best CI: 0.70). The model effectively stratified patients by LF risk in a Kaplan-Meier analysis (P < .001) and demonstrated an incremental net clinical benefit. At 24 months, we found LF in 9% and 74% of the low and high-risk groups, respectively. - CONCLUSIONS: A combination of clinical and radiomic features predicted freedom from LF better than any clinical feature set alone. Patients at high risk for LF may benefit from stricter follow-up routines or intensified therapy. | ||
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