eprintid: 10060912
rev_number: 16
eprint_status: archive
userid: 608
dir: disk0/10/06/09/12
datestamp: 2018-11-08 14:22:44
lastmod: 2020-02-12 22:04:07
status_changed: 2018-11-08 14:22:44
type: article
metadata_visibility: show
creators_name: Craigie, M
creators_name: Squires, J
creators_name: Miles, K
title: Can CT measures of tumour heterogeneity stratify risk for nodal metastasis in patients with non-small cell lung cancer
ispublished: pub
divisions: UCL
divisions: A01
divisions: B02
divisions: C10
divisions: D17
note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
abstract: AIM:
To undertake a preliminary assessment of the potential for computed tomography (CT) measurement of tumour heterogeneity to stratify risk of nodal metastasis in patients with non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS:
Tumour heterogeneity in CT images from combined positron-emission tomography (PET)/CT examinations in 150 consecutive patients with NSCLC was assessed using CT texture analysis (CTTA). The short axis diameter of the largest mediastinal node was also measured. Forty-two patients without distant metastases subsequently had tumour nodal status confirmed at surgery (n=26) or endobronchial ultrasound (EBUS; n=16). CTTA parameters and largest nodal diameter were related to nodal status using the rank correlation and the risk ratio for each nodal stage (>N0, >N1, >N2) was compared between patients categorised as high and low risk by CTTA or nodal size. The most significant predictor of nodal status was related to overall survival using Kaplan–Meier analysis.

RESULTS:
N-stage was more significantly correlated with CTTA than nodal diameter (Rs = -0.39, p=0.011, Rs = -0.45, p=0.0025, Rs = -0.40, p=0.0091 for normalised standard deviation (SD), normalised entropy and kurtosis respectively; Rs = -0.39, p=0.042 for nodal diameter). The presence of two or more high-risk CTTA values was the greatest risk factor for mediastinal metastasis (risk ratio: 11.0, 95% confidence interval: 1.56–77.8, p=0.0014) and was associated with significantly poorer overall survival (p=0.016).

CONCLUSION:
CTTA in NSCLC is related to nodal status in patients without distant metastases and has the potential to inform selection of investigative strategies for the assessment of mediastinal malignancy.
date: 2017-10
date_type: published
publisher: W B SAUNDERS CO LTD
official_url: https://doi.org/10.1016/j.crad.2017.04.013
oa_status: green
full_text_type: other
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1296439
doi: 10.1016/j.crad.2017.04.013
lyricists_name: Miles, Kenneth
lyricists_id: KAMIL11
actors_name: Miles, Kenneth
actors_id: KAMIL11
actors_role: owner
full_text_status: public
publication: Clinical Radiology
volume: 72
number: 10
pagerange: 899.e1-899.e7
pages: 7
issn: 1365-229X
citation:        Craigie, M;    Squires, J;    Miles, K;      (2017)    Can CT measures of tumour heterogeneity stratify risk for nodal metastasis in patients with non-small cell lung cancer.                   Clinical Radiology , 72  (10)   899.e1-899.e7.    10.1016/j.crad.2017.04.013 <https://doi.org/10.1016/j.crad.2017.04.013>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10060912/1/CRAD-D-17-00149%20submission.pdf