Defining the biological basis of radiomic phenotypes in lung cancer

  1. Patrick Grossmann
  2. Olya Stringfield
  3. Nehme El-Hachem
  4. Marilyn M Bui
  5. Emmanuel Rios Velazquez
  6. Chintan Parmar
  7. Ralph TH Leijenaar
  8. Benjamin Haibe-Kains
  9. Philippe Lambin
  10. Robert Gillies
  11. Hugo JWL Aerts  Is a corresponding author
  1. Dana-Farber Cancer Institute, United States
  2. H. Lee Moffitt Cancer Center and Research Institute, United States
  3. Institut de recherches cliniques de Montreal, Canada
  4. Research Institute GROW, Maastricht University, Netherlands
  5. University Health Network, Canada
  6. H. Lee Moffitt Cancer Center and Research Institute, United Kingdom

Abstract

Medical imaging can visualize characteristics of human cancer noninvasively. Radiomics is an emerging field that translates these medical images into quantitative data to enable phenotypic profiling of tumors. While radiomics has been associated with several clinical endpoints, the complex relationships of radiomics, clinical factors, and tumor biology are largely unknown. To this end, we analyzed two independent cohorts of respectively 262 North American and 89 European patients with lung cancer, and consistently identified previously undescribed associations between radiomic imaging features, molecular pathways, and clinical factors. In particular, we found a relationship between imaging features, immune response, inflammation, and survival, which was further validated by immunohistochemical staining. Moreover, a number of imaging features showed predictive value for specific pathways; for example, intra-tumor heterogeneity features predicted activity of RNA polymerase transcription (AUC=0.62, p=0.03) and intensity dispersion was predictive of the autodegration pathway of a ubiquitin ligase (AUC = 0.69, p < 10-4). Finally, we observed that prognostic biomarkers performed highest when combining radiomic, genetic, and clinical information (CI=0.73, p<10-9) indicating complementary value of these data. In conclusion, we demonstrate that radiomic approaches permit noninvasive assessment of both molecular and clinical characteristics of tumors, and therefore have the potential to advance clinical decision-making by systematically analyzing standard of care medical images.

Data availability

The following previously published data sets were used

Article and author information

Author details

  1. Patrick Grossmann

    Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, United States
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-4918-6902
  2. Olya Stringfield

    Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center and Research Institute, Tampa, United States
    Competing interests
    No competing interests declared.
  3. Nehme El-Hachem

    Integrative systems biology, Institut de recherches cliniques de Montreal, Montreal, Canada
    Competing interests
    No competing interests declared.
  4. Marilyn M Bui

    Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, United States
    Competing interests
    No competing interests declared.
  5. Emmanuel Rios Velazquez

    Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, United States
    Competing interests
    No competing interests declared.
  6. Chintan Parmar

    Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, United States
    Competing interests
    No competing interests declared.
  7. Ralph TH Leijenaar

    Department of Radiation Oncology (MAASTRO), Research Institute GROW, Maastricht University, Maastricht, Netherlands
    Competing interests
    No competing interests declared.
  8. Benjamin Haibe-Kains

    Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
    Competing interests
    No competing interests declared.
  9. Philippe Lambin

    Department of Radiation Oncology (MAASTRO), Research Institute GROW, Maastricht University, Maastricht, Netherlands
    Competing interests
    No competing interests declared.
  10. Robert Gillies

    Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center and Research Institute, Tampa, United Kingdom
    Competing interests
    Robert Gillies, declares a collaboration with HealthMyne..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-8888-7747
  11. Hugo JWL Aerts

    Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, United States
    For correspondence
    hugo_aerts@dfci.harvard.edu
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-2122-2003

Funding

National Institutes of Health (NIH-USA U24CA194354)

  • Hugo JWL Aerts

National Institutes of Health (NIH-USA U01CA190234)

  • Hugo JWL Aerts

National Institutes of Health (NIH/NCI U01CA143062)

  • Robert Gillies

National Institutes of Health (NIH/NCI P50CA119997)

  • Robert Gillies

QuIC-ConCePT (IMI JU Grant No. 115151)

  • Philippe Lambin

Technologiestichting STW (10696 DuCA)

  • Philippe Lambin

Dutch Cancer Society (KWF UM 2009-4454)

  • Philippe Lambin

Dutch Cancer Society (KWF MAC 2013-6425)

  • Philippe Lambin

Gattuso Slaight Personalized Cancer Medicine Fund

  • Benjamin Haibe-Kains

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Trever Bivona, University of California, San Francisco, United States

Ethics

Human subjects: The University of South Florida institutional review board approved and waived the informed consent requirement (IRB # 16069) retrospective study of Dataset1; data were collected and handled in accordance with the Health Insurance Portability and Accountability Act. Informed consent for gene expression collection was written and oral. For acquisition of imaging and clinical data USF IRB approved protocol (108426) provided a waiver of informed consent for this retrospective study. Data collection and analysis of Dataset2 was carried out in accordance with Dutch law; the corresponding institutional review board approved the study. All patient data were anonymized and de-identified prior to the analyses.

Version history

  1. Received: November 20, 2016
  2. Accepted: July 17, 2017
  3. Accepted Manuscript published: July 21, 2017 (version 1)
  4. Version of Record published: September 8, 2017 (version 2)
  5. Version of Record updated: February 13, 2018 (version 3)

Copyright

© 2017, Grossmann et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

Metrics

  • 6,417
    views
  • 1,260
    downloads
  • 256
    citations

Views, downloads and citations are aggregated across all versions of this paper published by eLife.

Download links

A two-part list of links to download the article, or parts of the article, in various formats.

Downloads (link to download the article as PDF)

Open citations (links to open the citations from this article in various online reference manager services)

Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)

  1. Patrick Grossmann
  2. Olya Stringfield
  3. Nehme El-Hachem
  4. Marilyn M Bui
  5. Emmanuel Rios Velazquez
  6. Chintan Parmar
  7. Ralph TH Leijenaar
  8. Benjamin Haibe-Kains
  9. Philippe Lambin
  10. Robert Gillies
  11. Hugo JWL Aerts
(2017)
Defining the biological basis of radiomic phenotypes in lung cancer
eLife 6:e23421.
https://doi.org/10.7554/eLife.23421

Share this article

https://doi.org/10.7554/eLife.23421

Further reading

    1. Cancer Biology
    Danielle Algranati, Roni Oren ... Efrat Shema
    Research Article

    Diffuse midline gliomas (DMGs) are aggressive and fatal pediatric tumors of the central nervous system that are highly resistant to treatments. Lysine to methionine substitution of residue 27 on histone H3 (H3-K27M) is a driver mutation in DMGs, reshaping the epigenetic landscape of these cells to promote tumorigenesis. H3-K27M gliomas are characterized by deregulation of histone acetylation and methylation pathways, as well as the oncogenic MYC pathway. In search of effective treatment, we examined the therapeutic potential of dual targeting of histone deacetylases (HDACs) and MYC in these tumors. Treatment of H3-K27M patient-derived cells with Sulfopin, an inhibitor shown to block MYC-driven tumors in vivo, in combination with the HDAC inhibitor Vorinostat, resulted in substantial decrease in cell viability. Moreover, transcriptome and epigenome profiling revealed synergistic effect of this drug combination in downregulation of prominent oncogenic pathways such as mTOR. Finally, in vivo studies of patient-derived orthotopic xenograft models showed significant tumor growth reduction in mice treated with the drug combination. These results highlight the combined treatment with PIN1 and HDAC inhibitors as a promising therapeutic approach for these aggressive tumors.

    1. Cancer Biology
    2. Cell Biology
    Alex Weiss, Cassandra D'Amata ... Madeline N Hayes
    Research Article

    High-throughput vertebrate animal model systems for the study of patient-specific biology and new therapeutic approaches for aggressive brain tumors are currently lacking, and new approaches are urgently needed. Therefore, to build a patient-relevant in vivo model of human glioblastoma, we expressed common oncogenic variants including activated human EGFRvIII and PI3KCAH1047R under the control of the radial glial-specific promoter her4.1 in syngeneic tp53 loss-of-function mutant zebrafish. Robust tumor formation was observed prior to 45 days of life, and tumors had a gene expression signature similar to human glioblastoma of the mesenchymal subtype, with a strong inflammatory component. Within early stage tumor lesions, and in an in vivo and endogenous tumor microenvironment, we visualized infiltration of phagocytic cells, as well as internalization of tumor cells by mpeg1.1:EGFP+ microglia/macrophages, suggesting negative regulatory pressure by pro-inflammatory cell types on tumor growth at early stages of glioblastoma initiation. Furthermore, CRISPR/Cas9-mediated gene targeting of master inflammatory transcription factors irf7 or irf8 led to increased tumor formation in the primary context, while suppression of phagocyte activity led to enhanced tumor cell engraftment following transplantation into otherwise immune-competent zebrafish hosts. Altogether, we developed a genetically relevant model of aggressive human glioblastoma and harnessed the unique advantages of zebrafish including live imaging, high-throughput genetic and chemical manipulations to highlight important tumor-suppressive roles for the innate immune system on glioblastoma initiation, with important future opportunities for therapeutic discovery and optimizations.