Prediction of PD-L1 expression in NSCLC patients using PET/CT radiomics and prognostic modelling for immunotherapy in PD-L1-positive NSCLC patients.
Authors
Affiliations (9)
Affiliations (9)
- PET-CT/MRI Department, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, Heilongjiang, China. Electronic address: [email protected].
- PET-CT/MRI Department, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, Heilongjiang, China. Electronic address: [email protected].
- PET-CT/MRI Department, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, Heilongjiang, China. Electronic address: [email protected].
- Scientific Research Center Department, Beijing General Electric Company, No.2 Yongchang North Road, Yizhuang Economic and Technological Development Zone, Daxing District, Beijing, 102200, China. Electronic address: [email protected].
- MR Research China, GE Healthcare, Beijing, 100176, China. Electronic address: [email protected].
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin, China. Electronic address: [email protected].
- PET-CT/MRI Department, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, Heilongjiang, China. Electronic address: [email protected].
- PET-CT/MRI Department, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, Heilongjiang, China. Electronic address: [email protected].
- PET-CT/MRI Department, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, Heilongjiang, China. Electronic address: [email protected].
Abstract
To develop a positron emission tomography/computed tomography (PET/CT)-based radiomics model for predicting programmed cell death ligand 1 (PD-L1) expression in non-small cell lung cancer (NSCLC) patients and estimating progression-free survival (PFS) and overall survival (OS) in PD-L1-positive patients undergoing first-line immunotherapy. We retrospectively analysed 143 NSCLC patients who underwent pretreatment <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) PET/CT scans, of whom 86 were PD-L1-positive. Clinical data collected included gender, age, smoking history, Tumor-Node-Metastases (TNM) staging system, pathologic types, laboratory parameters, and PET metabolic parameters. Four machine learning algorithms-Bayes, logistic, random forest, and Supportsupport vector machine (SVM)-were used to build models. The predictive performance was validated using receiver operating characteristic (ROC) curves. Univariate and multivariate Cox analyses identified independent predictors of OS and PFS in PD-L1-positive expression patients undergoing immunotherapy, and a nomogram was created to predict OS. A total of 20 models were built for predicting PD-L1 expression. The clinical combined PET/CT radiomics model based on the SVM algorithm performed best (area under curve for training and test sets: 0.914 and 0.877, respectively). The Cox analyses showed that smoking history independently predicted PFS. SUVmean, monocyte percentage and white blood cell count were independent predictors of OS, and the nomogram was created to predict 1-year, 2-year, and 3-year OS based on these three factors. We developed PET/CT-based machine learning models to help predict PD-L1 expression in NSCLC patients and identified independent predictors of PFS and OS in PD-L1-positive patients receiving immunotherapy, thereby aiding precision treatment.