Ya-Ching Hung, Sara C Chaker, Matthew Sigel, Mariam Saad, Monal Yu-Hsuan Chang, Elizabeth D Slater
Addressing Current Deficits in Patient Education Materials Through Crowdsourcing
Annals of plastic surgery
surgical resection standard care patients large symptomatic brain metastases bms despite improved local control adjuvant stereotactic radiotherapy risk local failure lf persists therefore aimed develop externally validate pretherapeutic radiomicsbased prediction tool identify patients high lf risk data collected multicenter analysis stereotactic radiotherapy resection cavity brain metastases aurora retrospective study training cohort 253 patients two centers external test cohort 99 patients five centers radiomic features extracted contrastenhancing bm t1ce mri sequence surrounding edema flair sequence different combinations radiomic clinical features compared final models trained entire training cohort best parameter set previously determined internal 5fold crossvalidation tested external test set best performance external test achieved elastic net regression model trained combination radiomic clinical features concordance index ci 077 outperforming clinical model best ci 070 model effectively stratified patients lf risk kaplanmeier analysis p 0001 demonstrated incremental net clinical benefit 24 months found lf 9 74 low highrisk groups respectively combination clinical radiomic features predicted freedom lf better clinical feature set alone patients high risk lf may benefit stricter followup routines intensified therapy