Abstract 870P
Background
To investigate possible value of radiomic FDG PET analysis in the assessment of neoadjuvant chemotherapy response and post-surgery decision-making in locally advanced cervical cancer (LACC).
Methods
We evaluated women with LACC, treated with cisplatin neoadjuvant chemotherapy (NACT) at our Institute, between 2014-2018, classified as Ib3-IIb clinical FIGO. MRI was performed to evaluate NACT response and plan radical surgery. RECIST1.1 were applied to MRI defining good- (CR, PR>50%) vs poor-responders (PR<50%, SD, PD). All the patients performed a PET after NACT. Primary tumor volume (VOI) was delineated, applying an estimated SUVmax threshold and a semiautomatic algorithm on 3DSlicer. On VOI, 136 fist-second order features were extracted by Pyradiomics. After hysterectomy, patients were treated with adjuvant therapies or followed- up, according to Sedlis criteria. Wilcoxon’s test was performed to compare features with NACT response (Outcome1) and post-surgery decision-making (Outcome2). Interactions between FIGO, age and outcome1/outcome2 results were tested (Fisher). Principal component analysis (PCA) was carried out to reduce dimension features and investigate relationships between them. Group differences in principal components were assessed using Hotelling’s T-squared test.
Results
We evaluated 27 women (mean age 46; range 24-77); 13/27 classified as Ib3 FIGO, 14/27 as IIa-IIb. Twentyone (77.8%) patients were classified as good responders and 6 (22.3%) as poor. Eighteen (66.7%) were followed-up and 9 (33.3%) treated with adjuvant therapies. Considering radiomic analysis, 26 features resulted significant in evaluating Outcome1, 12 in Outcome2. Considering PCA, the first (PC1) and the second (PC2) component explained 61.5% and 15.3% of overall variability, respectively. PC1 had multiple significant positive correlations with 25 features and negative correlation with 6. Evaluating Outcome1, the PC1 and PC2 were statistically significant in predicting good- from poor-responders (p= 0.04). No statistical differences were found considering Outcome 2. Fisher's test was not significant.
Conclusions
Radiomic analysis of PET performed after NACT can have a role in the assessment of therapy response and post- surgery decision-making.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.