Ultrasound-guided targeted biopsies of CT-based radiomic tumour habitats: technical development and initial experience i
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Ultrasound-guided targeted biopsies of CT-based radiomic tumour habitats: technical development and initial experience in metastatic ovarian cancer Lucian Beer 1,2,3 & Paula Martin-Gonzalez 3,4 & Maria Delgado-Ortet 1,3 & Marika Reinius 1,3,4 & Leonardo Rundo 1,3 & Ramona Woitek 1,2,3 & Stephan Ursprung 1,3 & Lorena Escudero 1,3 & Hilal Sahin 1,3 & Ionut-Gabriel Funingana 3,4 & Joo-Ern Ang 3,4,5 & Mercedes Jimenez-Linan 6 & Tristan Lawton 7 & Gaurav Phadke 7 & Sally Davey 8 & Nghia Q. Nguyen 9 & Florian Markowetz 3,4 & James D. Brenton 3,4 & Mireia Crispin-Ortuzar 3,4 & Helen Addley 1,3,5 & Evis Sala 1,3 Received: 15 July 2020 / Revised: 29 September 2020 / Accepted: 23 November 2020 # The Author(s) 2020
Abstract Purpose To develop a precision tissue sampling technique that uses computed tomography (CT)–based radiomic tumour habitats for ultrasound (US)-guided targeted biopsies that can be integrated in the clinical workflow of patients with high-grade serous ovarian cancer (HGSOC). Methods Six patients with suspected HGSOC scheduled for US-guided biopsy before starting neoadjuvant chemotherapy were included in this prospective study from September 2019 to February 2020. The tumour segmentation was performed manually on the pre-biopsy contrast-enhanced CT scan. Spatial radiomic maps were used to identify tumour areas with similar or distinct radiomic patterns, and tumour habitats were identified using the Gaussian mixture modelling. CT images with superimposed habitat maps were co-registered with US images by means of a landmark-based rigid registration method for US-guided targeted biopsies. The dice similarity coefficient (DSC) was used to assess the tumour-specific CT/US fusion accuracy. Results We successfully co-registered CT-based radiomic tumour habitats with US images in all patients. The median time between CT scan and biopsy was 21 days (range 7–30 days). The median DSC for tumour-specific CT/US fusion accuracy was 0.53 (range 0.79 to 0.37). The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76–0.79) while it was lower for the smaller omental metastases (DSC: 0.37–0.53). Conclusion We developed a precision tissue sampling technique that uses radiomic habitats to guide in vivo biopsies using CT/ US fusion and that can be seamlessly integrated in the clinical routine for patients with HGSOC. Key Points • We developed a prevision tissue sampling technique that co-registers CT-based radiomics–based tumour habitats with US images. • The CT/US fusion accuracy was high for the larger pelvic tumours (DSC: 0.76–0.79) while it was lower for the smaller omental metastases (DSC: 0.37–0.53). Keywords Ovarian neoplasms . Radiomics . Computed tomography Lucian Beer and Paula Martin-Gonzalez contributed equally to this work. * Evis Sala [email protected] 1
Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
2
Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, 1090 Vienna, Austria
3
Cancer Research UK Cambridge Centre, Uni
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