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
5683 - Prevention of chemoradiation-related mucositis in patients with head and neck cancer using dexamethasone-based mouthwash: A phase II randomized double-blind, placebo-controlled study
Presenter: Naiyarat Prasongsook
Session: Poster Display session 1
Resources:
Abstract
5437 - Salivary cytokines and oral mucosa cells apoptosis in patients during hematopoietic cell transplantation: possible relationship with oral mucositis
Presenter: Luciana Corrêa
Session: Poster Display session 1
Resources:
Abstract
1483 - A randomized trial of sodium alginate prevention of radiation-induced esophagitis in patients with locally advanced NSCLC receiving concurrent chemoradiotherapy: OLCSG1401
Presenter: Toshihide Yokoyama
Session: Poster Display session 1
Resources:
Abstract
2047 - Taste and smell alterations (TSAs) in patients (pts) with stage II-III colon cancer (CC): a pilot within the PROTECT study
Presenter: Jeroen Derksen
Session: Poster Display session 1
Resources:
Abstract
5984 - Clinical characteristics are associated with acupuncture treatment response for xerostomia in cancer patients
Presenter: Wenli Liu
Session: Poster Display session 1
Resources:
Abstract
2845 - Psychosocial Distress of Adolescent and Young Adults with Cancer at Diagnosis: A Case-Matched Retrospective Cohort of 2045 Patients in British Columbia.
Presenter: Alannah Smrke
Session: Poster Display session 1
Resources:
Abstract
724 - Accuracy of distress thermometer to measure cancer-related mood disorders in Chinese patients with cancer
Presenter: Sudip Thapa
Session: Poster Display session 1
Resources:
Abstract
2357 - Modalities of biosimilar filgrastim use in clinical practice in >1000 patients receiving chemotherapy regimens with a rest period of ≤14 days: the TOPAZE study
Presenter: Jean Marc Phelip
Session: Poster Display session 1
Resources:
Abstract
1426 - The Effect of Increasing Doses of Pegfilgrastim (Peg) on Thrombocytopenia (T) in Breast Cancer (BC) Patients (pts) Receiving Taxotere (Doc), Doxorubicin, Cyclophosphamide (TAC) and Plinabulin (Plin)
Presenter: Douglas Blayney
Session: Poster Display session 1
Resources:
Abstract
712 - The use of intravenous ferric carboxymaltose without erythropoiesis-stimulating agents in the treatment of anemia in cancer patients undergoing chemotherapy with or without radiotherapy
Presenter: Hikmat Abdel-Razeq
Session: Poster Display session 1
Resources:
Abstract