Detection of Local Cancer Recurrence After Stereotactic Ablative Radiation Therapy for Lung Cancer: Physician...

Area of Science:

• Medical Imaging
• Oncology
• Radiology

Background:

• Stereotactic ablative radiation therapy (SABR) is a standard treatment for early-stage lung cancer.
• Post-SABR fibrosis can complicate the detection of local recurrence on CT scans.
• Accurate and timely detection of local recurrence is crucial for effective patient management.

Purpose of the Study:

• To evaluate physician accuracy in detecting local recurrence after SABR.
• To compare physician performance with a radiomics tool for recurrence detection.
• To assess the potential of radiomics as a decision support system for early intervention.

Main Methods:

• Retrospective analysis of 182 CT scans from 45 patients treated with SABR.
• Scans were independently reviewed by 6 blinded thoracic imaging specialists.
• Radiomic features were extracted, and a radiomics signature was developed and compared to physician assessments.

Main Results:

• Physicians had a median sensitivity of 83% and specificity of 75% with moderate agreement (κ=0.54).
• Early detection (<6 months) showed a physician false negative rate (FNR) of 99%.
• A radiomics signature achieved an AUC of 0.85 with a 23% FNR, significantly outperforming physicians in early recurrence detection.

Conclusions:

• Radiomics can identify early signs of local recurrence missed by physicians.
• This radiomics tool shows potential as a decision support system for early detection.
• Early detection via radiomics may facilitate timely salvage therapy for lung cancer patients post-SABR.