Open AccessCorrelation of CT texture changes with treatment response during radiation therapy for esophageal cancer: An exploratory study
Author(s) -
Zhenning Yan,
Jingqiao Zhang,
Hai Long,
Xiaojiang Sun,
Dingjie Li,
Tian Tang,
X. Allen Li,
Hui Wang
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0223140
Subject(s) - medicine , radiation therapy , correlation , esophageal cancer , carcinoma , esophageal squamous cell carcinoma , nuclear medicine , cancer , mathematics , geometry
Purpose To analyze the change of CT texture features of esophageal squamous cell carcinoma (ESC) during RT delivery and to correlate these changes with the RT responses and survival. Methods A total of 61 ESC patients received radical RT were screened. Weekly CTs (4–6 sets for each patient) were acquired during RT. The tumors, normal esophageal mucosa tissue (NEC) of 5 cm and the spinal cord in the relevant area were delineated. CT texture features were extracted with a home-made tool. The changes of these features were analyzed by t-test. The correlations of the changes of features with RT responses and with patient survival were investigated by Pearson analysis. Results The average changes were increased by 0.00072 ±0.00197 for coarseness, by 0.14 ±0.40 for entropy, and by 2.34 ±3.56 for strength. In addition, the average changes were reduced by 8.88 ±15.71cc for volume and by 0.07 ±0.11 for busyness. The changes of the coarseness, strength, STD and entropy in ESC were different for the good and poor response groups. The survival rate of the patients was significantly correlated with the change of coarseness and strength ( P = 0.0027 and P = 0.0001). Conclusions During RT, changes of CT texture features of ESC, e.g., coarseness, strength, STD, entropy and volume are correlated with radiation response and survival rate. With more clinical data and robust research, CT features, e.g., coarseness and strength, can be selected as outstanding imaging biomarkers for prediction of RT prognosis of ESC.