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Deep-Learning Assessed Muscular Hypodensity Independently Predicts Mortality in DLBCL Patients Younger Than 60 Years

Maxime Jullien 1, 2 Benoit Tessoulin 1, 2 Hervé Ghesquières 3, 4, 5 Lucie Oberic 6 Franck Morschhauser 7, 8, 9 Hervé Tilly 10 Vincent Ribrag 11, 12, 13 Thierry Lamy 14 Catherine Thieblemont 15, 16 Bruno Villemagne 17 Rémy Gressin 18 Kamal Bouabdallah 19 Corinne Haioun 20 Gandhi Damaj 21 Luc-Matthieu Fornecker 22, 23 Jean-Marc Schiano de Colella 24 Pierre Feugier 25 Olivier Hermine 26 Guillaume Cartron 27, 28 Christophe Bonnet 29, 30 Marc André 31, 32 Clément Bailly 2 René-Olivier Casasnovas 33, 34 Steven Le Gouill 1, 2 
1 CRCINA-ÉQUIPE 10 - Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma
CRCINA - Centre de Recherche en Cancérologie et Immunologie Nantes-Angers
Abstract : 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.
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Maxime Jullien, Benoit Tessoulin, Hervé Ghesquières, Lucie Oberic, Franck Morschhauser, et al.. Deep-Learning Assessed Muscular Hypodensity Independently Predicts Mortality in DLBCL Patients Younger Than 60 Years. Cancers, MDPI, 2021, 13 (18), pp.4503. ⟨10.3390/cancers13184503⟩. ⟨inserm-03540506⟩

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