Radiomics-based Assessment of Radiation-induced Lung Injury After Stereotactic Body Radiotherapy

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Abstract

Background

Over 50% of patients who receive stereotactic body radiotherapy (SBRT) develop radiographic evidence of radiation-induced lung injury. Radiomics is an emerging approach that extracts quantitative features from image data, which may provide greater value and a better understanding of pulmonary toxicity than conventional approaches. We aimed to investigate the potential of computed tomography-based radiomics in characterizing post-SBRT lung injury.

Methods

A total of 48 diagnostic thoracic computed tomography scans (acquired prior to SBRT and at 3, 6, and 9 months post-SBRT) from 14 patients were analyzed. Nine radiomic features (ie, 7 gray level co-occurrence matrix [GLCM] texture features and 2 first-order features) were investigated. The ability of radiomic features to distinguish radiation oncologist-defined moderate/severe lung injury from none/mild lung injury was assessed using logistic regression and area under the receiver operating characteristic curve (AUC). Moreover, dose-response curves (DRCs) for radiomic feature changes were determined as a function of time to investigate whether there was a significant dose-response relationship.

Results

The GLCM features (logistic regression P-value range, 0.012-0.262; AUC range, 0.643-0.750) outperformed the first-order features (P-value range, 0.100-0.990; AUC range, 0.543-0.661) in distinguishing lung injury severity levels. Eight of 9 radiomic features demonstrated a significant dose-response relationship at 3, 6, and 9 months post-SBRT. Although not statistically significant, the GLCM features showed clear separations between the 3- or 6-month DRC and the 9-month DRC.

Conclusion

Radiomic features significantly correlated with radiation oncologist-scored post-SBRT lung injury and showed a significant dose-response relationship, suggesting the potential for radiomics to provide a quantitative, objective measurement of post-SBRT lung injury.

Micro-Abstract

Radiation-induced lung injury is common after stereotactic body radiotherapy (SBRT). For the first time, we characterized post-SBRT lung injury using computed tomography-based radiomics for 14 patients. Radiomic features significantly correlated with radiation oncologist-scored lung injury and showed significant dose-response relationships, suggesting the potential for radiomics to provide a quantitative, objective measurement of post-SBRT lung injury.

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