195P Radiomics and dosiomics signature from whole lung predicts radiation pneumonitis: A model development study with prospective external validation and decision-curve analysis

Radiation pneumonitis (RP) is one of the common side effects radiotherapy in thoracic region. Radiomics and dosiomics quantifies information implicit within medical images dose distributions. In this study we demonstrated prognostic potential radiomics, dosiomics, clinical features for RP prediction. Radiomics, dose-volume histogram (DVH) metrics, parameters were obtained on 314 retrospectively-collected 35 prospectively-enrolled patients diagnosed with lung cancer between 2013 to 2019. A radiomics risk score (R-score) (D-score) DVH-score calculated based logistic regression after feature selection. Seven models built using different combinations R-score, D-score, evaluate their added power. The DVH model was as a classical comparison model. Over-optimism evaluated by bootstrap resampling from training set, prospectively-collected cohort used external test set. Model calibration decision-curve characteristics best-performing evaluated. For ease further evaluation, nomograms constructed selected models. integrating all had best discriminative ability area under curves (AUCs) 0.793 (95%CI 0.735-0.851),0.774 0.762-0.786), 0.855 0.719-0.990) bootstrapping respectively. results curve decision analysis showed that final nomogram has future application.Table: 195PModelTrain (95%CI)Validation (95%CI)Testing (95%CI)R-score0.676 (0.606-0.745)0.619 (0.592-0.646)0.671 (0.558-0.899)D-score0.728 (0.665-0.790)0.687 (0.667-0.706)0.684 (0.573-0.883)DVH-score0.637 (0.570-0.705)0.628 (0.613-0.642)0.661 (0.551-0.856)Clinical parameters0.664 (0.594-0.735)0.654 (0.628-0.680)0.709 (0.509-0.91)R-score + D-score0.735 (0.673-0.796)0.729 (0.720-0.736)0.739 (0.553-0.926)R-score C0.717 (0.652-0.782)0.701 (0.683-0.719)0.771 (0.585-0.962)D-score C0.770 (0.710-0.830)0.755 (0.744-0.765)0.756 (0.559-0.954)R-score D-score C0.793 (0.735-0.851)0.774 (0.762-0.786)0.855 (0.719-0.990) Open table new tab have assist prediction RP.