Geometric features of pulmonary arteries are associated with early progression and progression-free survival in small-cell lung cancer patients treated with chemotherapy and immunotherapy

We investigated whether geometric features of pulmonary arteries are associated with early progression or progression-free survival at twelve months following initiation of combined immunotherapy and chemotherapy treatment in patients with extensive stage small cell lung cancer (SCLC). We utilized pre-treatment Computerized Tomography (CT) scans of 64 patients’ lungs to create skeletonized networks of patients’ pulmonary arteries, and a machine learning model was used to determine associations of geometric and clinical features with treatment response and survival. Geometric analyses achieved a ROC-AUC of 0.63 ± 0.23 for the ipsilateral geometric model and 0.61 ± 0.13 for the geometric model incorporating geometric features from both lungs, both higher than that of the clinical model alone, 0.58 ± 0.08. Additionally, the combined clinical and geometric model yielded a ROC-AUC of 0.64 ± 0.25 for the ipsilateral model and 0.67 ± 0.10 for the model incorporating features from both lungs, both higher than that of the clinical model alone.