Abstract 2751
Background
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal (GI) tract. The size, the presence of a c-KIT gene mutation and the mitotic index are used to determine the prognosis and to direct systemic treatment choices. This study evaluated the use of radiomics, a technique which uses algorithms for diagnosing and predicting the c-KIT mutational status and mitotic index of GISTs from medical imaging features.
Methods
A combination of machine learning methods was used to distinguish treatment-naive GISTs from other GI tumors resembling GISTs on imaging, based on clinical and molecular characteristics, as well as imaging features extracted from the contrast-enhanced venous phase computed tomography scans. Evaluation was performed in a 100x random-split cross-validation with 20% of the data for testing.
Results
A total of 242 tumors were used for distinguishing GISTs (n = 123) from non-GISTs (n = 119) including leiomyoma (n = 25), schwannoma (n = 21), gastric carcinoma (n = 25), lymphoma (n = 23) and leiomyosarcoma (n = 25).The non-GISTs were located either gastric (23%) or non-gastric (77%) and the GISTs were located either gastric (63%) or non-gastric (37%). A c-KIT mutation was present in the majority of the GISTs (exon 9 n = 10, exon 11 n = 56, exon 13 n = 2). The dataset originated from 65 different scanners, leading to heterogeneity in the imaging protocols. Imaging feature analyses showed a mean area under the curve (mAUC) of 0.70 (95% confidence interval [CI] 0.63-0.76) for distinguishing GIST from non-GISTs. A mAUC of 0.52 (95% CI 0.32-0.72) was found for predicting all c-KIT mutations, a mAUC of 0.51 (95% CI 0.29-0.72) for predicting a c-KIT exon 9 mutation, and a mAUC of 0.61 (95% CI 0.47-0.74) for predicting a c-KIT exon 11 mutation. The mitotic index was available in 83 patients (≤5/50 high power fields (HPFs) n = 53, 43.1%, >5/50 HPFs n = 33, 26.8%), and showed a mAUC of 0.60 (95% CI 0.47-0.73).
Conclusions
This pilot study showed the potential of radiomics to distinguish GIST from other GI tumors, but no potential in predicting c-KIT mutational status and mitotic index of GISTs. Further optimization and validation of the radiomics model is required to incorporate radiomics in the diagnostic routine of GISTs.
Clinical trial identification
Editorial acknowledgement
M.J. Timbergen and M.P.A. Starmans contributed equally to this study.
Legal entity responsible for the study
The authors.
Funding
The Netherlands Organization for Scientific Research.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3620 - Safety, efficacy, PK and PD biomarker results of the first-in-human study of mutant isocitrate dehydrogenase 1 (mIDH1) inhibitor BAY 1436032 in patients (pts) with mIDH1 advanced solid tumours
Presenter: Wolfgang Wick
Session: Poster Display session 1
Resources:
Abstract
5465 - Proof of concept clinical study by US-guided intratumor injection of VCN-01, an oncolytic adenovirus expressing hyaluronidase in patients with pancreatic cancer
Presenter: Manuel Hidalgo
Session: Poster Display session 1
Resources:
Abstract
2555 - A Phase 1a/b first-in-human, open-label, dose-escalation, safety, PK and PD study of TP-0903 in solid tumors
Presenter: John Sarantopoulos
Session: Poster Display session 1
Resources:
Abstract
3533 - First in human phase 1/2a study of PEN-866, a Heat Shock Protein 90 (HSP90) ligand – SN38 conjugate for patients with advanced solid tumors: Phase 1 results
Presenter: Johanna Bendell
Session: Poster Display session 1
Resources:
Abstract
4114 - A Phase I Open-Label, Non-Randomized Study of Recombinant Super-Compound Interferon (rSIFN-co) In Patients with Advanced Solid Tumors
Presenter: Amanda Seet
Session: Poster Display session 1
Resources:
Abstract
2537 - Evaluation of Pharmacodynamic (PD) Biomarkers in Advanced Cancer Patients Treated with Oxidative Phosphorylation (OXPHOS) Inhibitor, OPC-317 (OPC)
Presenter: Jie Qing Eu
Session: Poster Display session 1
Resources:
Abstract
5764 - Pharmacokinetic (PK) assessment of BT1718: A phase 1/2a study of BT1718, a first in class Bicycle Toxin Conjugate (BTC), in patients (pts) with advanced solid tumours
Presenter: Natalie Cook
Session: Poster Display session 1
Resources:
Abstract
2683 - A phase I open label dose escalation trial evaluating VT1021 in patients with advanced solid tumors.
Presenter: Wael Harb
Session: Poster Display session 1
Resources:
Abstract
3609 - Interim Results from Trial of SL-801, a Novel XPO-1 Inhibitor, in Patients with Advanced Solid Tumors
Presenter: Judy Wang
Session: Poster Display session 1
Resources:
Abstract
3485 - Phase 1 Trial of Fruquintinib in Patients with Advanced Solid Tumors: Results of the Dose Escalation Phase
Presenter: Andrea Wang-Gillam
Session: Poster Display session 1
Resources:
Abstract