Applying a computer-aided scheme to detect a new radiographic image marker for prediction of chemotherapy outcome

BACKGROUND To investigate the feasibility of automated segmentation of visceral and subcutaneous fat areas from computed tomography (CT) images of ovarian cancer patients and applying the computed adiposity-related image features to predict chemotherapy outcome. METHODS A computerized image processing scheme was developed to segment visceral and subcutaneous fat areas, and compute adiposity-related image features. Then, logistic regression models were applied to analyze association between the scheme-generated assessment scores and progression-free survival (PFS) of patients using a leave-one-case-out cross-validation method and a dataset involving 32 patients. RESULTS The correlation coefficients between automated and radiologist's manual segmentation of visceral and subcutaneous fat areas were 0.76 and 0.89, respectively. The scheme-generated prediction scores using adiposity-related radiographic image features significantly associated with patients' PFS (p < 0.01). CONCLUSION Using a computerized scheme enables to more efficiently and robustly segment visceral and subcutaneous fat areas. The computed adiposity-related image features also have potential to improve accuracy in predicting chemotherapy outcome.