T2-weighted magnetic resonance imaging radiogenomic features for the prediction of neoadjuvant chemotherapy response in patients with osteosarcoma

Background Osteosarcoma (OS) is the most common primary malignant bone tumor. Exploring quantitative parameters that reflect the outcome of neoadjuvant chemotherapy (NACT) in patients with OS can help advance the treatment of patients. Purpose To explore the role of T2-weighted (T2W) magnetic resonance imaging (MRI) radiogenomic features in characterizing changes in patients with OS and on NACT. Material and Methods A total of 21 patients with OS were examined retrospectively and divided into a poor-response group (n = 13) and a good-response group (n = 8). A total of 98 radiomic features and 31 gene expression profiles were analyzed for each patient. Age, sex, alkaline phosphatase, pathologic type, tumor size, and tumor location were also analyzed. Comparisons between the good- and poor-response groups were made using the t -test, Mann–Whitney U test, or Fisher's exact test. The relationships between radiomic features and gene expression profiles were conducted using Spearman’s correlative analyses. Results Statistical differences in 19 radiomics features and glutathione-s-transferase 1 were found between the good- and poor-response groups ( P < 0.05). The receiver operating characteristic curve showed that four NGTDM busyness features had the best performance in predicting the NACT of patients with OS, with an area under the curve of 0.788, sensitivity of 0.750, and specificity of 0.923. Correlation analysis showed that the HLA_I , CD274 , GSTP1 , and CCND3 were significantly correlated with one or more radiomics features ( P < 0.05). Conclusion The T2W MRI radiogenomic features can be used as biomarkers for the early response evaluation of NACT in OS. This is the first study to analyze the association of T2 radiogenomic features with NACT in patients with OS to assist in the assessment of NACT.