Thorstad, Wade L. | Search NASA

DOE OSTI2022

Image analysis reveals differences in tumor multinucleations in Black and White patients with human papillomavirus‐associated oropharyngeal squamous cell carcinoma

Background Understanding biological differences between different racial groups of human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC) patients, who have differences in terms of incidence, survival, and tumor morphology, can facilitate accurate prognostic biomarkers, which can help develop personalized treatment strategies. Methods This study evaluated whether there were morphologic differences between HPV‐associated tumors from Black and White patients in terms of multinucleation index (MuNI), an image analysis‐derived metric that measures density of multinucleated tumor cells within epithelial regions on hematoxylin–eosin images and previously has been prognostic in HPV‐associated OPSCC patients. In this study, the authors specifically evaluated whether the same MuNI cutoff that was prognostic of overall survival (OS) and disease‐free survival in their previous study, T TR , is valid for Black and White patients, separately. We also evaluated population‐specific cutoffs, T B for Blacks and T W for Whites, for risk stratification. Results MuNI was statistically significantly different between Black (mean, 3.88e–4; median, 3.67e–04) and White patients (mean, 3.36e–04; median, 2.99e–04), with p = .0078. Using T TR , MuNI was prognostic of OS in the entire population with hazard ratio (HR) of 1.71 ( p = .002; 95% confidence interval [CI], 1.21–2.43) and in White patients with HR of 1.72 ( p = .005; 95% CI, 1.18–2.51). Population‐specific cutoff, T W , yielded improved HR of 1.77 ( p = .003; 95% CI, 1.21–2.58) for White patients, whereas T B did not improve risk‐stratification in Black patients with HR of 0.6 ( p = .3; HR, 0.6; 95% CI, 0.2–1.80). Conclusions Histological difference between White and Black patient tumors in terms of multinucleated tumor cells suggests the need for considering population‐specific prognostic biomarkers for personalized risk stratification strategies for HPV‐associated OPSCC patients.

Koyuncu, Can F.↗

DOE OSTI2015

Automated contouring error detection based on supervised geometric attribute distribution models for radiation therapy: A general strategy

Purpose: One of the most critical steps in radiation therapy treatment is accurate tumor and critical organ-at-risk (OAR) contouring. Both manual and automated contouring processes are prone to errors and to a large degree of inter- and intraobserver variability. These are often due to the limitations of imaging techniques in visualizing human anatomy as well as to inherent anatomical variability among individuals. Physicians/physicists have to reverify all the radiation therapy contours of every patient before using them for treatment planning, which is tedious, laborious, and still not an error-free process. In this study, the authors developed a general strategy based on novel geometric attribute distribution (GAD) models to automatically detect radiation therapy OAR contouring errors and facilitate the current clinical workflow. Methods: Considering the radiation therapy structures’ geometric attributes (centroid, volume, and shape), the spatial relationship of neighboring structures, as well as anatomical similarity of individual contours among patients, the authors established GAD models to characterize the interstructural centroid and volume variations, and the intrastructural shape variations of each individual structure. The GAD models are scalable and deformable, and constrained by their respective principal attribute variations calculated from training sets with verified OAR contours. A new iterative weighted GAD model-fitting algorithm was developed for contouring error detection. Receiver operating characteristic (ROC) analysis was employed in a unique way to optimize the model parameters to satisfy clinical requirements. A total of forty-four head-and-neck patient cases, each of which includes nine critical OAR contours, were utilized to demonstrate the proposed strategy. Twenty-nine out of these forty-four patient cases were utilized to train the inter- and intrastructural GAD models. These training data and the remaining fifteen testing data sets were separately employed to test the effectiveness of the proposed contouring error detection strategy. Results: An evaluation tool was implemented to illustrate how the proposed strategy automatically detects the radiation therapy contouring errors for a given patient and provides 3D graphical visualization of error detection results as well. The contouring error detection results were achieved with an average sensitivity of 0.954/0.906 and an average specificity of 0.901/0.909 on the centroid/volume related contouring errors of all the tested samples. As for the detection results on structural shape related contouring errors, an average sensitivity of 0.816 and an average specificity of 0.94 on all the tested samples were obtained. The promising results indicated the feasibility of the proposed strategy for the detection of contouring errors with low false detection rate. Conclusions: The proposed strategy can reliably identify contouring errors based upon inter- and intrastructural constraints derived from clinically approved contours. It holds great potential for improving the radiation therapy workflow. ROC and box plot analyses allow for analytically tuning of the system parameters to satisfy clinical requirements. Future work will focus on the improvement of strategy reliability by utilizing more training sets and additional geometric attribute constraints.

60 APPLIED LIFE SCIENCES↗