Prognostic role of radiomics-based body composition analysis for the 1-year survival for hepatocellular carcinoma patients

Sylvia Saalfeld; Robert Kreher; Georg Hille; Uli Niemann; Mattes Hinnerichs; Osman Öcal; Kerstin Schütte; Christoph J Zech; Christian Loewe; Otto van Delden; Vincent Vandecaveye; Chris Verslype; Bernhard Gebauer; Christian Sengel; Irene Bargellini; Roberto Iezzi; Thomas Berg; Heinz J Klümpen; Julia Benckert; Antonio Gasbarrini; Holger Amthauer; Bruno Sangro; Peter Malfertheiner; Bernhard Preim; Jens Ricke; Max Seidensticker; Maciej Pech; Alexey Surov

doi:10.1002/jcsm.13315

Prognostic role of radiomics-based body composition analysis for the 1-year survival for hepatocellular carcinoma patients

J Cachexia Sarcopenia Muscle. 2023 Oct;14(5):2301-2309. doi: 10.1002/jcsm.13315. Epub 2023 Aug 17.

Authors

Sylvia Saalfeld^{1

2}, Robert Kreher^{1

2}, Georg Hille^{1

2}, Uli Niemann³, Mattes Hinnerichs⁴, Osman Öcal⁵, Kerstin Schütte^{6

7}, Christoph J Zech⁸, Christian Loewe⁹, Otto van Delden¹⁰, Vincent Vandecaveye¹¹, Chris Verslype¹², Bernhard Gebauer¹³, Christian Sengel¹⁴, Irene Bargellini¹⁵, Roberto Iezzi^{16

17}, Thomas Berg¹⁸, Heinz J Klümpen¹⁹, Julia Benckert²⁰, Antonio Gasbarrini²¹, Holger Amthauer²², Bruno Sangro²³, Peter Malfertheiner²⁴, Bernhard Preim^{1

2}, Jens Ricke⁵, Max Seidensticker⁵, Maciej Pech⁴, Alexey Surov²⁵

Affiliations

¹ Research Campus STIMULATE at the University of Magdeburg, Magdeburg, Germany.
² Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany.
³ University Library, University of Magdeburg, Magdeburg, Germany.
⁴ Department of Radiology and Nuclear Medicine, OvGU Magdeburg, Magdeburg, Germany.
⁵ Department of Radiology, LMU University Hospital, Munich, Germany.
⁶ Department of Internal Medicine and Gastroenterology, Niels-Stensen-Kliniken Marienhospital, Osnabrück, Germany.
⁷ Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover (MHH), Hannover, Germany.
⁸ Department of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.
⁹ Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
¹⁰ Department of Radiology and Nuclear Medicine, Academic University Medical Centers, Amsterdam, The Netherlands.
¹¹ Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
¹² Department of Digestive Oncology, University Hospitals Leuven, Leuven, Belgium.
¹³ Department of Radiology, Charité - University Medicine Berlin, Berlin, Germany.
¹⁴ Department of Radiology, Grenoble University Hospital, La Tronche, France.
¹⁵ Diagnostic and Interventional Radiology, Candiolo Cancer Institute, Turin, Italy.
¹⁶ Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia d'Urgenza e Interventistica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy.
¹⁷ Università Cattolica del Sacro Cuore, Rome, Italy.
¹⁸ Klinik und Poliklinik für Gastroenterologie, Sektion Hepatologie, Universitätsklinikum Leipzig, Leipzig, Germany.
¹⁹ Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
²⁰ Department of Hepatology and Gastroenterology, Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²¹ Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
²² Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany.
²³ Liver Unit, Clínica Universidad de Navarra and CIBEREHD, Pamplona, Spain.
²⁴ Department of Medicine II, University Hospital, LMU Munich, Munich, Germany.
²⁵ Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany.

Abstract

Background: Parameters of body composition have prognostic potential in patients with oncologic diseases. The aim of the present study was to analyse the prognostic potential of radiomics-based parameters of the skeletal musculature and adipose tissues in patients with advanced hepatocellular carcinoma (HCC).

Methods: Radiomics features were extracted from a cohort of 297 HCC patients as post hoc sub-study of the SORAMIC randomized controlled trial. Patients were treated with selective internal radiation therapy (SIRT) in combination with sorafenib or with sorafenib alone yielding two groups: (1) sorafenib monotherapy (n = 147) and (2) sorafenib and SIRT (n = 150). The main outcome was 1-year survival. Segmentation of muscle tissue and adipose tissue was used to retrieve 881 features. Correlation analysis and feature cleansing yielded 292 features for each patient group and each tissue type. We combined 9 feature selection methods with 10 feature set compositions to build 90 feature sets. We used 11 classifiers to build 990 models. We subdivided the patient groups into a train and validation cohort and a test cohort, that is, one third of the patient groups.

Results: We used the train and validation set to identify the best feature selection and classification model and applied it to the test set for each patient group. Classification yields for patients who underwent sorafenib monotherapy an accuracy of 75.51% and area under the curve (AUC) of 0.7576 (95% confidence interval [CI]: 0.6376-0.8776). For patients who underwent treatment with SIRT and sorafenib, results are accuracy = 78.00% and AUC = 0.8032 (95% CI: 0.6930-0.9134).

Conclusions: Parameters of radiomics-based analysis of the skeletal musculature and adipose tissue predict 1-year survival in patients with advanced HCC. The prognostic value of radiomics-based parameters was higher in patients who were treated with SIRT and sorafenib.

Keywords: HCC; body composition; radiomics; sarcopenia.

Abstract

Grants and funding