Canadian Urological Association journal = Journal de l Association des urologues du Canada | 2021
Development of a radiomic signature for predicting response to neoadjuvant chemotherapy in muscle-invasive bladder cancer.
Abstract
INTRODUCTION\nNeoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) improves overall survival, but pathological response rates are low. Predictive biomarkers could select those patients most likely to benefit from NAC. Radiomics technology offers a novel, noninvasive method to identify predictive biomarkers. Our study aimed to develop a predictive radiomics signature for response to NAC in MIBC.\n\n\nMETHODS\nAn institutional bladder cancer database was used to identify MIBC patients who were treated with NAC followed by radical cystectomy. Patients were classified into responders and non-responders based on pathological response. Bladder lesions on computed tomography images taken prior to NAC were contoured. Extracted radiomics features were used train a radial basis function support vector machine classifier to learn a prediction rule to distinguish responders from non-responders. The discriminative accuracy of the classifier was then tested using a nested 10-fold cross-validation protocol.\n\n\nRESULTS\nNineteen patients who underwent NAC followed by radical cystectomy were found to be eligible for analysis. Of these, nine (48%) patients were classified as responders and 10 (52%) as non-responders. Nineteen bladder lesions were contoured. The sensitivity, specificity and discriminative accuracy were 52.9±9.4%, 69.4±8.6%, and 62.1±6.1%, respectively. This corresponded to an area under the curve of 0.63±0.08 (p=0.20).\n\n\nCONCLUSIONS\nOur developed radiomics signature demonstrated modest discriminative accuracy; however, these results may have been influenced by small sample size and heterogeneity in image acquisition. Future research using novel methods for computer-based image analysis on a larger cohort of patients is warranted.