TY - JOUR
T1 - Validation of the 18F-FDG PET image biomarker model predicting late xerostomia after head and neck cancer radiotherapy
AU - Li, Yan
AU - Sijtsema, Nanna Maria
AU - de Vette, Suzanne Petronella Maria
AU - Steenbakkers, Roel Johannes Henricus Marinus
AU - Zhang, Fan
AU - Noordzij, Walter
AU - Van den Bosch, Lisa
AU - Langendijk, Johannes Albertus
AU - van Dijk, Lisanne Vania
N1 - Funding Information:
Dr. Lisanne van Dijk, received/receives funding and salary support from the Dutch organization NWO ZonMw for the execution of this study via VENI (NWO-09150162010173) Individual career development grant; KWF Dutch Cancer Society Young Investigator Grant (KWF-13529).
Funding Information:
Yan Li received/receives funding and salary support from the China Scholarship Council grant (202008110193).
Funding Information:
Prof. Langendijk received/receives unrelated funding from the Dutch Cancer Society and the European Union during this study.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/3
Y1 - 2023/3
N2 - Background and purpose: Previously, PET image biomarkers (PET-IBMs) – the 90th percentile standardized uptake value (P90-SUV) and the Mean SUV (Mean-SUV) of the contralateral parotid gland (cPG) – were identified as predictors for late-xerostomia following head and neck cancer (HNC) radiotherapy. The aim of the current study was to assess in an independent validation cohort whether these pre-treatment PET-IBM can improve late-xerostomia prediction compared to the prediction with baseline xerostomia and mean cPG dose alone. Materials and methods: The prediction endpoint was patient-rated moderate-to-severe xerostomia at 12 months after radiotherapy. The PET-IBMs were extracted from pre-treatment 18 F-FDG PET images. The performance of the model (base model) with baseline xerostomia and mean cPG dose alone and models with additionally P90-SUV or Mean-SUV were tested in the current independent validation cohort. Specifically, model discrimination (area under the curve: AUC) and calibration (calibration plot) were evaluated. Results: The current validation cohort consisted of 137 patients of which 40% developed moderate-to-severe xerostomia at 12 months. Both the PET-P90 model (AUC:PET-P90 = 0.71) and the PET-Mean model (AUC: PET-Mean = 0.70) performed well in the current validation cohort. Moreover, their performance were improved compared to the base model (AUC:base model= 0.68). The calibration plots showed a good fit of the prediction to the actual rates for all tested models. Conclusion: PET-IBMs showed an improved prediction of late-xerostomia when added to the base model in this validation cohort. This contributed to the published hypothesis that PET-IBMs include individualized information and can serve as a pre-treatment risk factor for late-xerostomia.
AB - Background and purpose: Previously, PET image biomarkers (PET-IBMs) – the 90th percentile standardized uptake value (P90-SUV) and the Mean SUV (Mean-SUV) of the contralateral parotid gland (cPG) – were identified as predictors for late-xerostomia following head and neck cancer (HNC) radiotherapy. The aim of the current study was to assess in an independent validation cohort whether these pre-treatment PET-IBM can improve late-xerostomia prediction compared to the prediction with baseline xerostomia and mean cPG dose alone. Materials and methods: The prediction endpoint was patient-rated moderate-to-severe xerostomia at 12 months after radiotherapy. The PET-IBMs were extracted from pre-treatment 18 F-FDG PET images. The performance of the model (base model) with baseline xerostomia and mean cPG dose alone and models with additionally P90-SUV or Mean-SUV were tested in the current independent validation cohort. Specifically, model discrimination (area under the curve: AUC) and calibration (calibration plot) were evaluated. Results: The current validation cohort consisted of 137 patients of which 40% developed moderate-to-severe xerostomia at 12 months. Both the PET-P90 model (AUC:PET-P90 = 0.71) and the PET-Mean model (AUC: PET-Mean = 0.70) performed well in the current validation cohort. Moreover, their performance were improved compared to the base model (AUC:base model= 0.68). The calibration plots showed a good fit of the prediction to the actual rates for all tested models. Conclusion: PET-IBMs showed an improved prediction of late-xerostomia when added to the base model in this validation cohort. This contributed to the published hypothesis that PET-IBMs include individualized information and can serve as a pre-treatment risk factor for late-xerostomia.
KW - FDG-PET
KW - Head and neck cancer
KW - Model validation
KW - Radiomics
KW - Xerostomia
UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-85146162634&partnerID=MN8TOARS
U2 - 10.1016/j.radonc.2022.109458
DO - 10.1016/j.radonc.2022.109458
M3 - Article
C2 - 36608769
AN - SCOPUS:85146162634
SN - 0167-8140
VL - 180
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 109458
ER -