210P - Lung tumour vascularity is a risk factor for survival in NSCLC patients undergoing surgery

Background

Vascularization is known to be linked to tumour growth. We explored the potential of automated lung tumour vascularity assessment as risk factor for landmark survival.

Methods

131 CT scans from the NSCLC Radiogenomics dataset were evaluated. All patients underwent surgery, with or without other therapies. Primary lung tumour (PLT) is segmented by a radiologist. Vessels segmentation (arteries and veins) is performed by an in-house deep learning segmentation model. Vascularity features extracted for the PLT include: amount of blood vessel connections, % of the tumour surface connected to vessels (%area), and basic statistics on the surface area of the connections. A generalized linear model (GLM) to predict landmark survival was trained with these features, tumour volume, and clinical factors. Stepwise feature reduction was performed to arrive to the final model. We present the odds ratio (OR) as well as a combined risk score for the remaining independent predictors.

Results

Landmark survival was reached for 86/131 (66%) patients. GLM analysis showed 4 independent risk factors related to landmark survival: %area (OR= 1.69 for >2.5%), age (OR=1.57 for >70 years), gender (OR=2.10 for male) and radiation therapy (OR=1.51 for yes). Smoking status and tumor volume were not retained in the final model. We also showed that risk of dying before landmark survival increased with increased number risk factors (0%, 18%, 40%, 48% and 100% for 0, 1, 2, 3, 4 risk factors, respectively).

Conclusions

Lung tumour vascularity is an independent risk factor for landmark survival. We showed an approach were it can be used as additional prognostic factor to inform clinical decision making and therapy planning.

Clinical trial identification

Editorial acknowledgement

Fabio Bottari, PhD, of Radiomics for providing medical writing support in accordance with Good Publication Practice ( GPP 2022) guidelines.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

F. Blistein, F. Belmans, S. Goffart, L. Libert, R. Narasimhan, A. Corsi: Financial Interests, Personal, Full or part-time Employment: Radiomics. W. Vos: Financial Interests, Personal, Leadership Role: Radiomics. M. Occhipinti: Financial Interests, Personal, Financially compensated role: Radiomics. All other authors have declared no conflicts of interest.