![[18F]FDG PET immunotherapy radiomics signature (iRADIOMICS) predicts response of non-small-cell lung cancer patients treated with pembrolizumab Cover](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647355c34e662f30ba53aa2a/cover-image.jpg)
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![Receiver operating characteristic (ROC) curve analysis. Blue: baseline iRADIOMICS multivariate logistic model (independent variables: Small Run Emphasis [SRE], Difference Entropy), yellow: baseline iRADIOMICS univariate logistic model (independent variable: SRE), grey: month 1 iRECIST univariate logistic model (independent variable: iRECIST response category), red: month 4 iRECIST univariate logistic model (independent variable: iRECIST response category). For each model, area under curve (AUC) and 95% confidence interval (CI) are reported.](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/647355c34e662f30ba53aa2a/j_raon-2020-0042_fig_003.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKHL7ER5IB%2F20260118%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20260118T231011Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjELr%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaDGV1LWNlbnRyYWwtMSJIMEYCIQDC540x9zF5aKgFDkSOTwbNpMYOXiye5VRS7sidCU0pHwIhAOdxiOEosvc5T0HYReevkcSOplr6XzcH0bmrSn%2FvnXdrKsQFCIP%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQAhoMOTYzMTM0Mjg5OTQwIgwdG676drOKiFdy6a0qmAXLSTY55Ak%2Fi7hrp4ayB1LqxXR1sFb%2FyQuLvrb57IDxZIjqJAfKdxn9RSJyR3A6RXO5kJjtGaDxFdX2VsW8Oc4c1y7hosd6fo6%2Bn1hA4bkZ4382daqSR6k85XVgomJ1t3ak4IWZU7U3YNyDPiwolvqyqvEq9gAgOYWbjes9th2gl6aTl%2F9rw8bs1npEKgkrO71KNKVj5aLBEQrB1uYbjQ3FHShVCxKNcrq7acyBN9Rir1eCqifX87oJFyG85KW4Js7mJdTMAcaVdxM4I7Cq1Ow1J3cCAUKSn41Zi%2FfjgHJRUN8p8HMqbCXnKnfNVbupAemqLlWHh5RaV3OF6eHb1%2FkkJrA5rS5DMB7J1bJrS7l%2BLU0SSgc48sc7tssNib%2FpOIiKLoyyGqnKnEscSe%2FbWQyde%2FAQ%2F%2FmLlvdu%2BeCj5CwSenz%2Ffbyv9ZCas5T5Jl9LNP7MPp5XNnimBSn1w190v9rqKhtm%2BnQl0werPBZija7w13%2F%2FtY6IVzb%2BBB2T4HI7TYSHk1jnHU4gQbnVJRJnfZxn2v7Xlq79e2UKSGTJrgZlMssK4Y86UzV6Xv%2BpnBY%2BsWS%2FxHhqFkejFmk1dUQ28dd0SQHRfZc%2BJ32jldaxiQGtAJjwt4PpDpVOMPMbsQrFH1%2BtbUZOUAiNUtz0K%2BBcMULKEVzCJ632CX497gXPZdg%2FCGEXTlix1JQZQIzwdE1GZRPiqn9dZ6319e%2B63uDYMCX2lBjMxKUmvW7qPR%2Bvk9cSxYYTXl7S2HgKM6ziBcVprmKXF5YQ8TE0BBKigV%2FEmb9T%2F%2BvYxmKcGOZ2iMe5dPC9GkmgGDc2Zaxjeh%2FsldIjhMywdgZAcaKgCk5zf6uys5EhO1zIKRBY225jOy9KHxCwpUeqx1NKsk0mMNO7tMsGOrAB3C2TMOREABZS%2BXnVNqLow5TsMAvKqicbqhHty5P31MiZi%2Fa8n0VSlCJAtFFwdfYyiqX60yfvu5%2FvoyOMJsH8aOK9VsLnxVNbyXQQyJryvsPax7hvKUthnXmhLSccACGHM27uvMMxcO%2BZvT0IjnaHpSxgceY0BJkP99A0ghuU730k8HwqtWOER9G2Yr2vFAqnqWmQjoU4MKKcfv2ZrSXGXKhszsyPoRY2YnUy0PvNwO4%3D&X-Amz-Signature=ce606f7e8585d0abd33a8823552aea252cc5e1c06fe1ff8b28d05d74eb5fbddc&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Patient demographic and clinical data_ The data is presented for all patients, responders (overall survival [OS] > 14_9 months), and non-responders (OS < 14_9 months)_ The reported p-value is the result of Mann-Whitney U-test (MWU) (continuous variables) and Fisher exact test (categorical variables) comparing differences between responders and non-responders
| Characteristic | All patients median (range) | Responders (OS > 14.9 months) median (range) | Non-responders (OS < 14.9 months) median (range) | p-value |
|---|---|---|---|---|
| Number of patients | 30 | 16 | 14 | |
| Age [years] | 65 (46–77) | 67 (48–76) | 61 (46–77) | 0.298 |
| PD-L1 TPS [%] | 75 (3–100) | 77.5 (3–100) | 75 (10–100) | 0.933 |
| Sex | 0.715 | |||
| Female | 15 | 9 | 6 | |
| Male | 15 | 7 | 8 | |
| Histology | 0.532 | |||
| Adenocarcinoma | 17 | 8 | 9 | |
| Squamous cell carcinoma | 8 | 4 | 4 | |
| Other | 5 | 4 | 1 | |
| Smoking status | 0.672 | |||
| Never | 1 | 0 | 1 | |
| Former > 3 years ago | 12 | 7 | 5 | |
| Former < 3 years ago | 5 | 3 | 2 | |
| Until current disease | 8 | 3 | 5 | |
| Current smoker | 4 | 3 | 1 | |
| ECOG PS | 0.162 | |||
| 0 | 8 | 2 | 6 | |
| 1 | 18 | 12 | 6 | |
| 2 | 4 | 2 | 2 | |
| Line of treatment (immunotherapy) | 0.096 | |||
| 1st | 15 | 10 | 5 | |
| 2nd | 13 | 4 | 9 | |
| 3rd | 2 | 2 | 0 | |
| Palliative RT during treatment | 0.657 | |||
| No | 24 | 12 | 12 | |
| Yes | 6 | 4 | 2 | |
Baseline radiomics features of primary tumours – Mann-Whitney U-test (MWU) and receiver operating characteristic (ROC) curve analysis_ Patients were dichotomized into 2 groups: responders (OS > 14_9 months) and non-responders (OS < 14_9 months)_ For each radiomics feature median value, range, p-value of MWU, and the area under the ROC curve (AUC) with the corresponding 95% confidence interval (CI), are reported_ See also Figure 1
| Feature | Responders (OS > 14.9 months) median (range) | Non-responders (OS < 14.9 months) median (range) | p-value | AUC (95% CI) |
|---|---|---|---|---|
| Volume [cm3] | 27.9 (2.64–351) | 44.4 (7.81–792) | 0.098 | 0.69 (0.49–0.89) |
| SUVmax [g/ml] | 20.6 (5.21–32.1) | 15.6 (9.54–37.0) | 0.185 | 0.65 (0.43–0.87) |
| Sum entropy | 3.69 (3.53–3.77) | 3.7 (3.54–3.76) | 0.387 | 0.60 (0.38–0.82) |
| Entropy-GLCM | 4.07 (3.99–4.15) | 4.11 (4.03–4.14) | 0.046 | 0.72 (0.52–0.92) |
| Difference entropy | 2.98 (2.74–3.07) | 2.89 (2.74–3.06) | 0.080 | 0.70 (0.49–0.90) |
| Small Run Emphasis (SRE) | 0.0382 (0.00962–0.0615) | 0.0163 (0.00854–0.0303) | 0.001 | 0.85 (0.69–1.00) |
Baseline radiomics features of primary tumours – univariate and multivariate Cox proportional hazards regression analysis (Cox PH)_ For each radiomics feature, the hazard ratio (HR), corresponding 95% confidence interval (CI), and p-value of univariate analysis are reported_ The 2-variable multivariate regression model was chosen based on the Akaike information criterion (AIC)_ In order to achieve comparable HRs, all radiomics features were normalized into z-scores
| Feature | Univariate HR (95% CI) | Univariate p-value | Multivariate HR (95% CI) | Multivariate p-value |
|---|---|---|---|---|
| Volume | 1.6 (1.1–2.4) | 0.015 | ||
| SUVmax | 0.77 (0.46–1.3) | 0.320 | ||
| Sum Entropy | 0.96 (0.60–1.5) | 0.860 | ||
| Entropy-GLCM | 1.4 (0.82–2.3) | 0.230 | ||
| Difference entropy | 0.62 (0.40–0.97) | 0.037 | 0.54 (0.31–0.93) | 0.026 |
| Small Run Emphasis (SRE) | 0.46 (0.26–0.81) | 0.007 | 0.39 (0.20–0.76) | 0.006 |