Prediction of Histologic Neoadjuvant Chemotherapy Response in Osteosarcoma Using Pretherapeutic MRI Radiomics.

Histologic response to chemotherapy for osteosarcoma is one of the most important prognostic factors for survival, but assessment occurs after surgery. Although tumor imaging is used for surgical planning and follow-up, it lacks predictive value. Therefore, a radiomics model was developed to predict the response to neoadjuvant chemotherapy based on pretreatment T1-weighted contrast-enhanced MRI. A total of 176 patients (median age, 20 years [range, 5-71 years]; 107 male patients) with osteosarcoma treated with neoadjuvant chemotherapy and surgery between January 2007 and December 2018 in three different centers in France (Centre Léon Bérard in Lyon, Centre Hospitalier Universitaire de Nantes in Nantes, and Hôpital Cochin in Paris) were retrospectively analyzed. Various models were trained from different configurations of the data sets. Two different methods of feature selection were tested with and without ComBat harmonization (ReliefF and t test) to select the most relevant features, and two different classifiers were used to build the models (an artificial neural network and a support vector machine). Sixteen radiomics models were built using the different combinations of feature selection and classifier applied on the various data sets. The most predictive model had an area under the receiver operating characteristic curve of 0.95, a sensitivity of 91%, and a specificity 92% in the training set; respective values in the validation set were 0.97, 91%, and 92%. In conclusion, MRI-based radiomics may be useful to stratify patients receiving neoadjuvant chemotherapy for osteosarcomas. Keywords: MRI, Skeletal-Axial, Oncology, Radiomics, Osteosarcoma, Pediatrics Supplemental material is available for this article. © RSNA, 2022.

[Prediction of chemotherapy response in primary osteosarcoma using the machine learning technique on radiomic data]. / Prédiction de la réponse à la chimiothérapie des ostéosarcomes à partir des données radiomiques issues des IRM diagnostiques.

INTRODUCTION: Osteosarcoma is the most common malignant bone tumor before 25 years of age. Response to neoadjuvant chemotherapy determines continuation of treatment and is also a powerful prognostic factor. There are currently no reliable ways to evaluate it early. The aim is to develop a method to predict the chemotherapy response using radiomics from pre-treatment MRI. METHODS: Clinical characteristics and MRI of patients treated for local or metastatic osteosarcoma were collected retrospectively in the Rhône-Alpes region, from 2007 to 2016. On initial MRI exams, each tumor was segmented by expert radiologist and 87 radiomic features were extracted automatically. Univariate analysis was performed to assess each feature's association with histological response following neoadjuvante chemotherapy. To distinguish good histological responder from poor, we built predictive models based on support vector machines. Their classification performance was assessed with the area under operating characteristic curve receiver (AUROC) from test data. RESULTS: The analysis focused on the MRIs of 69 patients, 55.1% (38/69) of whom were good histological responders. The model obtained by support vector machines from initial MRI radiomic data had an AUROC of 0.98, a sensitivity of 100% (IC 95% [100%-100%]) and specificity of 86% (IC 95% [59.7%-111%]). DISCUSSION: Radiomic based on MRI data would predict the chemotherapy response before treatment initiation, in patients treated for osteosarcoma.

Bilateral pulmonary thrombosis in a newborn with congenital nephrotic syndrome.

In the neonatal period, pulmonary thromboembolic episodes are rare and unknown events. Case of a preterm newborn who presented a bilateral thrombosis of the pulmonary arteries associated with a congenital nephrotic syndrome. Pediatricians should consider pulmonary thromboembolic episodes in cases of newborns with unexplained severe and hypoxic respiratory distress syndrome.