Post-processing steps improve generalisability and robustness of an MRI-based radiogenomic model for human papillomavirus status prediction in oropharyngeal cancer.

Authors

Ahmadian M,Bodalal Z,Bos P,Martens RM,Agrotis G,van der Hulst HJ,Vens C,Karssemakers L,Al-Mamgani A,de Graaf P,Jasperse B,Brakenhoff RH,Leemans CR,Beets-Tan RGH,Castelijns JA,van den Brekel MWM

Affiliations (13)

  • Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
  • Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
  • Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands.
  • GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
  • Department of Radiation Oncology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
  • Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Department of Radiology, University Hospital of Larissa, Thessaly, Greece.
  • School of Cancer Science, University of Glasgow, Glasgow, UK.
  • Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
  • Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
  • Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. [email protected].
  • Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands. [email protected].

Abstract

To assess the impact of image post-processing steps on the generalisability of MRI-based radiogenomic models. Using a human papillomavirus (HPV) status in oropharyngeal squamous cell carcinoma (OPSCC) prediction model, this study examines the potential of different post-processing strategies to increase its generalisability across data from different centres and image acquisition protocols. Contrast-enhanced T1-weighted MR images of OPSCC patients of two cohorts from different centres, with confirmed HPV status, were manually segmented. After radiomic feature extraction, the HPV prediction model trained on a training set with 91 patients was subsequently tested on two independent cohorts: a test set with 62 patients and an externally derived cohort of 157 patients. The data processing options included: data harmonisation, a process to ensure consistency in data from different centres; exclusion of unstable features across different segmentations and scan protocols; and removal of highly correlated features to reduce redundancy. The predictive model, trained without post-processing, showed high performance on the test set, with an AUC of 0.79 (95% CI: 0.66-0.90, p < 0.001). However, when tested on the external data, the model performed less well, resulting in an AUC of 0.52 (95% CI: 0.45-0.58, p = 0.334). The model's generalisability substantially improved after performing post-processing steps. The AUC for the test set reached 0.76 (95% CI: 0.63-0.87, p < 0.001), while for the external cohort, the predictive model achieved an AUC of 0.73 (95% CI: 0.64-0.81, p < 0.001). When applied before model development, post-processing steps can enhance the robustness and generalisability of predictive radiogenomics models. Question How do post-processing steps impact the generalisability of MRI-based radiogenomic prediction models? Findings Applying post-processing steps, i.e., data harmonisation, identification of stable radiomic features, and removal of correlated features, before model development can improve model robustness and generalisability. Clinical relevance Post-processing steps in MRI radiogenomic model generation lead to reliable non-invasive diagnostic tools for personalised cancer treatment strategies.

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Journal Article

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