Predicting chemotherapy response in pediatric lymphoma using pre-treatment contrast-enhanced CT radiomics: A
Yingxue Tong1, Haoru Wang1, Xiangmin Zhang1
1Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, 400014, Chongqing, China.
Purpose:
To preliminarily evaluate the predictive value of baseline contrast-enhanced CT (CECT) radiomics for assessing chemotherapy response in pediatric lymphoma.
Methods:
This retrospective study included 92 pediatric patients with lymphoma (72 males, 20 females). Patients were classified as responders (n = 74) and non-responders (n = 18) based on treatment outcomes. The cohort was randomly stratified into a training set (n = 65, 70%) and a test set (n = 27, 30%). A total of 960 radiomics features were extracted from venous-phase baseline CECT images of target lesions. Feature selection was performed, and a logistic regression model was developed for response classification using the Synthetic Minority Over-sampling Technique (SMOTE). To evaluate model robustness, the entire radiomics pipeline was repeated across 10 independent randomized train-test splits. Model performance was evaluated using receiver operating characteristic (ROC) curve analysis, reporting the area under the ROC curve (AUC), 95% confidence intervals (CIs), and accuracy.
Results:
Eight radiomics features were selected for the final model, including four filter-transformed first-order features and four filter-transformed texture features. The SMOTE model achieved an AUC of 0.883 (95% CI: 0.799-0.967) and an accuracy of 0.800 in the training set. In the test set, the SMOTE model achieved an AUC of 0.809 (95% CI: 0.606-1.000) and an accuracy of 0.741. In repeated validation, the SMOTE model showed mean AUCs of 0.915 (training) and 0.767 (test) across 10 splits.
Conclusion:
This hypothesis-generating study demonstrates that baseline CECT radiomics shows promise for predicting chemotherapy response in pediatric lymphoma.
