磁共振delta影像组学用于追踪接受立体定向MRI引导放疗的肺部肿瘤的放射反应
Magnetic resonance delta radiomics to track radiation response in lung tumors receiving stereotactic MRI-guided radiotherapy
AI总结：
本研究通过回顾性分析47次MR引导肺部SBRT治疗，验证了delta影像组学的可行性与稳定性，发现偏度等特征可追踪放射剂量反应并与局部复发相关，为个体化放疗剂量调整提供依据。
摘要：
引言：肺癌是癌症相关死亡的主要原因之一，立体定向体部放疗（SBRT）已成为早期肺癌的标准治疗手段。然而，肿瘤层面对放射的异质性反应带来了挑战。目前，标准化剂量方案缺乏基于个体患者或肿瘤特征的适应性调整。因此，我们探索利用治疗中磁共振（MR）影像的delta影像组学来追踪放射剂量反应、为个体化放疗剂量提供信息并预测治疗结局的潜力。方法：对39例患者共47次MR引导肺部SBRT治疗进行了回顾性研究。使用Pyradiomics提取影像组学特征，并在时间维度和空间维度上评估特征稳定性。将delta影像组学与放射剂量投照进行相关性分析，并通过Cox回归评估其与肿瘤控制和生存的关联。结果：在107个特征中，49个表现出时间稳定性，57个表现出空间稳定性。对15个稳定且非共线的特征进行了分析。中位偏度（Skewness）和表面积体积比随放射剂量分次投照而下降，而粗糙度（coarseness）和第90百分位数值则上升。偏度相对于基线每分次具有最大的相对中位绝对变化（22%-45%），并通过协方差分析与局部区域失败显著相关（p=0.012）。偏度、伸长率（Elongation）和平整度（Flatness）与局部无复发生存显著相关，而肿瘤直径和体积则无显著相关性。结论：本研究确立了delta影像组学分析在MR引导肺部SBRT中的可行性和稳定性。研究结果表明，MR delta影像组学能够捕捉肿瘤内放射效应的短期影像学表现。
英文摘要：
Introduction: Lung cancer is a leading cause of cancer-related mortality, and stereotactic body radiotherapy (SBRT) has become a standard treatment for early-stage lung cancer. However, the heterogeneous response to radiation at the tumor level poses challenges. Currently, standardized dosage regimens lack adaptation based on individual patient or tumor characteristics. Thus, we explore the potential of delta radiomics from on-treatment magnetic resonance (MR) imaging to track radiation dose response, inform personalized radiotherapy dosing, and predict outcomes. Methods: A retrospective study of 47 MR-guided lung SBRT treatments for 39 patients was conducted. Radiomic features were extracted using Pyradiomics, and stability was evaluated temporally and spatially. Delta radiomics were correlated with radiation dose delivery and assessed for associations with tumor control and survival with Cox regressions. Results: Among 107 features, 49 demonstrated temporal stability, and 57 showed spatial stability. Fifteen stable and non-collinear features were analyzed. Median Skewness and surface to volume ratio decreased with radiation dose fraction delivery, while coarseness and 90th percentile values increased. Skewness had the largest relative median absolute changes (22%-45%) per fraction from baseline and was associated with locoregional failure (p=0.012) by analysis of covariance. Skewness, Elongation, and Flatness were significantly associated with local recurrence-free survival, while tumor diameter and volume were not. Conclusions: Our study establishes the feasibility and stability of delta radiomics analysis for MR-guided lung SBRT. Findings suggest that MR delta radiomics can capture short-term radiographic manifestations of intra-tumoral radiation effect.
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