CT image feature analysis in distinguishing radiation fibrosis from tumour recurrence after stereotactic ablative radiotherapy (SABR) for lung cancer: a preliminary study

Sarah A. Mattonen; David A. Palma; Cornelis J. A. Haasbeek; Suresh Senan; Aaron D. Ward

doi:10.1117/12.2006456

29 March 2013 CT image feature analysis in distinguishing radiation fibrosis from tumour recurrence after stereotactic ablative radiotherapy (SABR) for lung cancer: a preliminary study

Sarah A. Mattonen, David A. Palma, Cornelis J. A. Haasbeek, Suresh Senan, Aaron D. Ward

Author Affiliations +

Proceedings Volume 8672, Medical Imaging 2013: Biomedical Applications in Molecular, Structural, and Functional Imaging; 86720L (2013) https://doi.org/10.1117/12.2006456
Event: SPIE Medical Imaging, 2013, Lake Buena Vista (Orlando Area), Florida, United States

Abstract

Radiation induced lung injury (RILI) is a common finding following lung radiotherapy and results in radiographic changes on computed tomography (CT). Stereotactic ablative radiotherapy (SABR) treats the tumour to a highly conformal dose with large doses/fraction, which can result in benign, tumour-mimicking radiographic changes. Our purpose was to determine the ability of quantitative measures of post-SABR radiographic changes to distinguish the subject groups (recurrence vs. RILI) at several time points. Two regions were manually contoured on each follow-up CT: consolidative changes and ground glass opacity (GGO). A peri-tumoural region of GGO was also taken around the consolidative changes. At 9 months, patients with recurrence had significantly denser consolidative areas compared to patients with RILI (p=.046) and significantly increased variability of CT densities in the GGO areas (p=.0078). The variability of CT density in a peri-tumoural region of 4 mm thickness was also significant at 9 months post-treatment (p=.0499). Our preliminary study of classification accuracy based on these measures showed that variability of the GGO CT density was the best predictor with a cross validation error of 26.1%, demonstrating that further refinement of the features and classifier may soon lead to a clinically useful computer-aided diagnosis tool. These results suggest the future potential to distinguish patients with recurrence from those RILI at 9 months post-SABR based on appearance characteristics within the consolidative, GGO, and peri-tumoural regions. This could potentially allow for earlier salvage of patients with recurrence, and result in fewer investigations of benign RILI.

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Sarah A. Mattonen, David A. Palma, Cornelis J. A. Haasbeek, Suresh Senan, and Aaron D. Ward "CT image feature analysis in distinguishing radiation fibrosis from tumour recurrence after stereotactic ablative radiotherapy (SABR) for lung cancer: a preliminary study", Proc. SPIE 8672, Medical Imaging 2013: Biomedical Applications in Molecular, Structural, and Functional Imaging, 86720L (29 March 2013); https://doi.org/10.1117/12.2006456

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