Research shows AI helps tailor treatment for rare sarcomas more accurately than biopsy

AI could be approximately twice as accurate as a biopsy at grading the aggressiveness of some sarcomas, according to research from The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research (ICR), London.

Results from the study published in The Lancet Oncology suggest that a new AI algorithm could help tailor the treatment of some sarcoma patients more accurately and effectively than a biopsy. The research also suggests that the technology could help clinicians diagnose sub-types of the rare disease, speeding up diagnosis. The researchers believe the technique could eventually be applied to other cancer types too.

This study focused on retroperitoneal sarcoma, a soft tissue sarcoma that develops in the back of the abdomen and, due to its location and rarity, is currently hard to diagnose and treat.

Researchers used the CT scans of 170 Royal Marsden patients with the two most common forms of retroperitoneal sarcoma – leiomyosarcoma and liposarcoma – to create an AI algorithm that was then tested on nearly 90 patients from centres across Europe and the USA. To analyse the scan data they used radiomics, which can extract information about the patient’s disease from medical images, including data that cannot be distinguished by the human eye.

The model accurately graded the risk of 82 per cent of the tumours analysed, while 44 per cent were correctly graded using a biopsy. The model also accurately predicted the disease type of 84 per cent of the sarcomas tested, meaning it can effectively differentiate between leiomyosarcoma and liposarcoma, compared with radiologists who were not able to diagnose 35 per cent of the cases.

By giving clinicians a more accurate and effective way of grading tumours, researchers hope this technology will improve the management of the disease and outcomes.

The study was supported by funding from The Royal Marsden Cancer Charity, the National Institute for Health and Care Research, the Wellcome Trust and the EORTC Soft Tissue and Bone Sarcoma Group.

First author Dr Amani Arthur, registrar at The Royal Marsden and clinical research fellow at the ICR, said: “In the next phase of the study, we will test this model in clinic on patients with potential retroperitoneal sarcomas to see if it can accurately characterise their disease and measure the performance of the technology over time.”

Study lead Professor Christina Messiou, consultant radiologist at The Royal Marsden and professor in imaging for personalised oncology at the ICR said: “This is the largest and most robust study to date that has successfully developed and tested an AI model aimed at improving the diagnosis and grading of retroperitoneal sarcoma using data from CT scans.

“We’re incredibly excited by the potential of this state-of-the-art technology, which could lead to patients having better outcomes through faster diagnosis and more effectively personalised treatment. As patients with retroperitoneal sarcoma are routinely scanned with CT, we hope this tool will eventually be used globally, ensuring that not just specialist centres – that see sarcoma patients every day – can reliably identify and grade the disease.”

Picture: First author Dr Amani Arthur and study lead Professor Christina Messiou.

Published on page 22 of the December 2023 issue of RAD Magazine.