Magnetic resonance imaging radiomic feature analysis of radiation-induced femoral head changes in prostate cancer radiotherapy
Hamid Abdollahi1, Seied Rabi Mahdavi2, Isaac Shiri3, Bahram Mofid4, Mohsen Bakhshandeh5, Kazem Rahmani6
1 Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Department of Medical Physics, School of Medicine; Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences; Department of Biomedical and Health Informatics, Rajaei Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
4 Department of Clinical Oncology, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Radiation Technology, Allied Medicine Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
Dr. Hamid Abdollahi
Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Junction of Shahid Hemmat and Shahid Chamran Expressways, Tehran 14496
Dr. Seied Rabi Mahdavi
Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran
Source of Support: None, Conflict of Interest: None
Background and Purpose: As a feasible approach, radiotherapy has a great role in prostate cancer (Pca) management. However, Pca patients have an increased risk of femoral head damages including fractures after radiotherapy. The mechanisms of these complications are unknown and time of manifestations is too long; however, they may be predicted by early imaging. The main purpose of this study was to assess the early changes in femoral heads in Pca patients treated with intensity-modulated radiation therapy (IMRT) using multiparametric magnetic resonance imaging (mpMRI) radiomic feature analysis.
Materials and Methods: Thirty Pca patients treated with IMRT were included in the study. All patients underwent two mpMRI pre- and postradiotherapy. Thirty-four robust radiomic features were extracted from T1, T2, and apparent diffusion coefficient (ADC) obtained from diffusion-weighted images. Wilcoxon signed-rank test was performed to assess the significance of the change in the mean T1, T2, and ADC radiomic features postradiotherapy relative to preradiotherapy values. The percentage change values were normalized based on the natural logarithm base ten. Features were also ranked based on their median changes.
Results: Sixty femoral heads were analyzed. All radiomic features have undergone changes. Significant postradiotherapy radiomic feature changes were observed in 20 and 5 T1- and T2-weighted radiomic features, respectively (P < 0.05). ADC features did not vary significantly postradiotherapy. The mean radiation dose received by femoral heads was 40 Gy. No fractures were observed within the follow-up time. Different features were found as high ranked among T1, T2, and ADC images.
Conclusion: Early structural change analysis using radiomic features may contribute to predict postradiotherapy fracture in Pca patients. These features can be identified as being potentially important imaging biomarkers for predicting radiotherapy-induced femoral changes.