Predicting survival after radiosurgery in patients with lung cancer brain metastases using deep learning of radiomics and EGFR status

Chien Yi Liao, Cheng Chia Lee, Huai Che Yang, Ching Jen Chen, Wen Yuh Chung, Hsiu Mei Wu, Wan Yuo Guo, Ren Shyan Liu, Chia Feng Lu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The early prediction of overall survival (OS) in patients with lung cancer brain metastases (BMs) after Gamma Knife radiosurgery (GKRS) can facilitate patient management and outcome improvement. However, the disease progression is influenced by multiple factors, such as patient characteristics and treatment strategies, and hence satisfactory performance of OS prediction remains challenging. Accordingly, we proposed a deep learning approach based on comprehensive predictors, including clinical, imaging, and genetic information, to accomplish reliable and personalized OS prediction in patients with BMs after receiving GKRS. Overall 1793 radiomic features extracted from pre-GKRS magnetic resonance images (MRI), clinical information, and epidermal growth factor receptor (EGFR) mutation status were retrospectively collected from 237 BM patients who underwent GKRS. DeepSurv, a multi-layer perceptron model, with 4 different aggregation methods of radiomics was applied to predict personalized survival curves and survival status at 3, 6, 12, and 24 months. The model combining clinical features, EGFR status, and radiomics from the largest BM showed the best prediction performance with concordance index of 0.75 and achieved areas under the curve of 0.82, 0.80, 0.84, and 0.92 for predicting survival status at 3, 6, 12, and 24 months, respectively. The DeepSurv model showed a significant improvement (p < 0.001) in concordance index compared to the validated lung cancer BM prognostic molecular markers. Furthermore, the model provided a novel estimate of the risk-of-death period for patients. The personalized survival curves generated by the DeepSurv model effectively predicted the risk-of-death period which could facilitate personalized management of patients with lung cancer BMs.

Original languageEnglish
Pages (from-to)585-596
Number of pages12
JournalPhysical and Engineering Sciences in Medicine
Volume46
Issue number2
DOIs
StatePublished - Jun 2023

Keywords

  • Brain metastases
  • Deep learning
  • Epidermal growth factor receptor
  • MRI radiomics
  • Radiosurgery
  • Survival prediction

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