Radiogenomics prediction for MYCN amplification in Neuroblastoma: a hypothesis generating study

Background: MYCN amplification represents a powerful prognostic factor in neuroblastoma (NB) and may occasionally account for intratumoral heterogeneity. Radiomics is an emerging field of advanced image analysis that aims to extract a large number of quantitative features from standard radiological images, providing valuable clinical information Procedure: In this retrospective study, we aimed to create a radiogenomics model by correlating computed tomography (CT) radiomics analysis with MYCN status and overall survival (OS). NB lesions were segmented on pre-therapy CT scans and radiomics features subsequently extracted using a dedicated library. Dimensionality reduction/features selection approaches were then used for features procession and logistic regression models have been developed for the considered outcome. Results: Seventy-eight patients were included in this study, 24 presented MYCN amplification. In total, 232 radiomics features were extracted. Eight features were selected through Boruta algorithm and 2 features were lastly chosen through Pearson correlation analysis: mean of voxel intensity histogram (p=0.0082) and zone size non-uniformity (p=0.038). Five-times repeated 3-fold cross-validation logistic regression models yielded an Area Under the Curve (AUC) value of 0.879 on the training and 0.865 on the testing set for MYCN. No statistical significant difference has been observed comparing radiomics predicted and actual OS data. Conclusions: CT based radiomics is able to predict MYCN amplification status and OS in NB, paving the way to the in depth analysis of imaging based biomarkers that could enhance outcomes prediction.