U-NET; convolutional neural network; diffuse large B-cell lymphoma; muscle depletion; muscle hypodensity; sarcopenia; UNET; Oncology; Cancer Research
Abstract :
[en] BACKGROUND: Muscle depletion (MD) assessed by computed tomography (CT) has been shown to be a predictive marker in solid tumors, but has not been assessed in non-Hodgkin's lymphomas. Despite software improvements, MD measurement remains highly time-consuming and cannot be used in clinical practice.
METHODS: This study reports the development of a Deep-Learning automatic segmentation algorithm (DLASA) to measure MD, and investigate its predictive value in a cohort of 656 diffuse large B cell lymphoma (DLBCL) patients included in the GAINED phase III prospective trial (NCT01659099).
RESULTS: After training on a series of 190 patients, the DLASA achieved a Dice coefficient of 0.97 ± 0.03. In the cohort, the median skeletal muscle index was 50.2 cm2/m2 and median muscle attenuation (MA) was 36.1 Hounsfield units (HU). No impact of sarcopenia was found on either progression free survival (PFS) or overall survival (OS). Muscular hypodensity, defined as MA below the tenth percentile according to sex, was associated with a lower OS and PFS, respectively (HR = 2.80 (95% CI 1.58-4.95), p < 0.001, and HR = 2.22 (95% CI 1.43-3.45), p < 0.001). Muscular hypodensity appears to be an independent risk factor for mortality in DLBCL and because of DLASA can be estimated in routine practice.
Disciplines :
Hematology
Author, co-author :
Jullien, Maxime ; Department of Hematology, Nantes University Hospital, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, 44000 Nantes, France
Tessoulin, Benoit; Department of Hematology, Nantes University Hospital, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, 44000 Nantes, France
Ghesquières, Hervé; Department of Hematology, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Claude Bernard Lyon-1 University, 69310 Pierre Bénite, France
Oberic, Lucie; Department of Hematology, IUC Toulouse Oncopole, 31000 Toulouse, France
Morschhauser, Franck; Department of Hematology, Univ. Lille, CHU Lille, EA 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, 59000 Lille, France
Tilly, Hervé; Department of Hematology, Centre H. Becquerel, 76000 Rouen, France
Ribrag, Vincent; Department of Hematology, Gustave Roussy, Université Paris-Saclay, 94800 Villejuif, France
Lamy, Thierry; Department of Hematology, University Hospital of Rennes, 35000 Rennes, France
Thieblemont, Catherine; Department of Hematology, APHP, Hopital Saint Louis, Université Paris Diderot, 75011 Paris, France
Villemagne, Bruno; Department of Hematology, Hopital Departemental de Vendée, 85000 La Roche sur Yon, France
Gressin, Rémy; Department of Hematology, CHU Grenoble, 38000 Grenoble, France
Bouabdallah, Kamal; Department of Hematology, University Hospital of Bordeaux, F-33000 Bordeaux, France
Haioun, Corinne; Lymphoïd Malignancies Unit, Hôpital Henri Mondor, AP-HP, 94000 Créteil, France
Damaj, Gandhi; Department of Hematology, Institut D'hématologie de Basse Normandie, 14000 Caen, France
Fornecker, Luc-Matthieu; Department of Hematology, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospital of Strasbourg, 67000 Strasbourg, France
Schiano De Colella, Jean-Marc; Department of Hematology, Institut P. Calmette, 13000 Marseille, France
Feugier, Pierre; Department of Hematology, University Hospital of Nancy, 54000 Nancy, France
Hermine, Olivier; Department of Hematology, Hopital Necker, F-75015 Paris, France
Cartron, Guillaume; Department of Clinical Hematology, University Hospital of Montpellier, UMR-CNRS 5535, 34000 Montpellier, France
BONNET, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'hématologie clinique
André, Marc; Department of Hematology, CHU UCL Namur, Université Catholique de Louvain, 5000 Namur, Belgium
Bailly, Clément ; Department of Nuclear Medicine, University Hospital of Nantes, 44000 Nantes, France
Casasnovas, René-Olivier; Department of Hematology, University Hospital F. Mitterrand and Inserm UMR 1231, 21000 Dijon, France
Le Gouill, Steven; Department of Hematology, Nantes University Hospital, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, 44000 Nantes, France
Conflicts of Interest: HG reports grants, personal fees or non-financial support from Gilead Sciences, Janssen, Celgene, Roche, Takeda; LO, Advisory board: Roche, Takeda; honoraria: Celgene, Janssen, Roche; FM has received honoraria from Bristol-Myers Squibb and Janssen and served as a consultant or advisor to Celgene, Bayer, Abbvie, Verasteem, Gilead, Servier, Roche/Genentech, and Epizyme; HT, Consulting and advisory board: Roche, Janssen-Cilag, Karyopharm, Astra-Zeneca, Lectures: Roche, Bristol-Myers-Squibb, Servier; VR Infinity Pharmaceuticals, Bristol-Myers Squibb, PharmaMar, Gilead Sciences, AZD, Epizyme, Incyte, MSD, Servier, Roche, arGEN-X BVBA; CT Honoraria: Amgen, Celgene, Jazz Pharma, Kyte/Gilead, Novartis, Servier, Roche, Janssen; Research funding: Roche, Celgene, Aspira; CH Honoraria: Roche, Janssen-Cilag, Gilead, Takeda, Miltenyi and Servier; Travel grants: Amgen and Celgene; GD Board: Roche, takeda; Travel: Roche AbbVie Pfizer, Grants: takeda, roche; LF Honoraria: Roche, AstraZeneca, Servier, Takeda, Abbvie, Janssen; Advisory boards: Takeda, Roche, Gilead, AbbVie, Janssen-Cilag; Travel grants: La Roche, Gilead, Abbvie and Janssen-Cilag; PF Roche Genentech, celgene, Abbvie, Janssen and gilead; OH, Celgene research grant, Alexion research grant, Ab science co-founder research grant consulting, Inatherys co-founder research grants; GC has received honoraria from Janssen, Sanofi, Abbvie, Gilead, Roche, Celgene, Novartis, Takeda and served as a consultant or Celgene, Roche/Genentech; CB is board member for Roche; MA: Advisory Board: Takeda, Bristol-Myers-Squibb, Karyopharm, Gilead, Incyte, Research Grants: Roche, Johnson & Johnson, Takeda, Travel Grants: Roche, Bristol-Myers-Squib, Celgene, Gilead, Abbvie; ROC reports grants, personal fees and non-financial support from Roche Genentech, during the conduct of the study; reports personal fees from MSD, BMS, Abbvie, Amgen, Celgene, reports grants and personal fees from Takeda, GILEAD/kite, outside the submitted work; SLG reports grants, personal fees or non-financial support from Roche Genentech, during the conduct of the study; reports personal fees from Celgene, reports grants and personal fees from Janssen-Cilag; GILEAD/kite, Servier outside the submitted work. All other authors declare no competing interests (M.J., B.T., T.L., B.V., R.G., K.B., J.-M.S.D.C.).Funding: The GAINED trial was funded by Roche SAS.
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