Function of <sup>18</sup>F-FDG PET/CT radiomics in the detection of checkpoint inhibitor-induced liver injury (CHILI).
Authors
Affiliations (7)
Affiliations (7)
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
- Department of Gastroenterology and Hepatology, Lausanne University Hospital, Lausanne, Switzerland.
- Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland.
- Department of Oncology, Geneva University Hospitals, Geneva, Switzerland.
- Lundin Family Brain Tumor Research Centre, Departments of Oncology and Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
- Institute of Informatics, School of Management, HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland, Sierre, Switzerland.
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland. [email protected].
Abstract
In the last decade, immunotherapy, particularly immune checkpoint inhibitors, has revolutionized cancer treatment and improved prognosis. However, severe checkpoint inhibitor-induced liver injury (CHILI), which can lead to treatment discontinuation or death, occurs in up to 18% of the patients. The aim of this study is to evaluate the value of PET/CT radiomics analysis for the detection of CHILI. Patients with CHILI grade 2 or higher who underwent liver function tests and liver biopsy were retrospectively included. Minors, patients with cognitive impairments, and patients with viral infections were excluded from the study. The patients' liver and spleen were contoured on the anonymized PET/CT imaging data, followed by radiomics feature extraction. Principal component analysis (PCA) and Bonferroni corrections were used for statistical analysis and exploration of radiomics features related to CHILI. Sixteen patients were included and 110 radiomics features were extracted from PET images. Liver PCA-5 showed significance as well as one associated feature but did not remain significant after Bonferroni correction. Spleen PCA-5 differed significantly between CHILI and non-CHILI patients even after Bonferroni correction, possibly linked to the higher metabolic function of the spleen in autoimmune diseases due to the recruitment of immune cells. This pilot study identified statistically significant differences in PET-derived radiomics features of the spleen and observable changes in the liver on PET/CT scans before and after the onset of CHILI. Identifying these features could aid in diagnosing or predicting CHILI, potentially enabling personalized treatment. Larger multicenter prospective studies are needed to confirm these findings and develop automated detection methods.