Your Donations in Action: David Cao, BS

Current staging for metastatic head and neck squamous cell carcinoma (HNSCC) relies on imaging, including contrast-enhancing soft-tissue CT. Although lymph node staging is an important prognostic variable in HNSCC, there is currently no method to accurately predict treatment response to induction chemotherapy in these patients.

Prior studies have shown that texture analysis, which quantifies visual parameters to conduct comparisons between images, can be used with standard imaging modalities like CT to uncover associations between visual parameters in head and neck primary tumors and patient outcomes.

In his 2020 FUJIFILM Medical Systems USA, Inc./RSNA Research Medical Student Grant, David Cao, BS, a University of Chicago medical student, sought to determine whether CT texture analysis of metastatic lymph nodes in HNSCC could be used as an accurate and non-invasive preoperative method to predict treatment response to induction chemotherapy.

Through a single-center retrospective study of patients with locally advanced human papillomavirus positive (HPV+) HNSCC, Cao and colleagues developed a radiomic model and a combined radiomic/ clinical model predicting lymph node response to induction chemotherapy using multivariable logistic regression.

“The combined model performed the best. A pretreatment CT-based lymph node radiomic signature combined with clinical parameters was able to predict nodal response to induction chemotherapy for patients with locally advanced HNSCC,” Cao said. “This research demonstrates that radiomic features of lymph nodes may provide useful information in predicting disease response to induction chemotherapy.”

Cao hopes prediction of individual nodal response could lead to more personalized radiation dose intensification focusing on high-risk nodes or even direct surgical dissection for high-risk nodes. He recognized the assistance the R&E grant provided.

“Along with the support of my mentor, Dr. Daniel Ginat, this grant was crucial for funding the time and opportunity to pursue this study as one of my first forays into clinical research and an exploration into one of my interests, the intersection of technology and medicine,” Cao said. “The skills and insight gained from this experience will prove invaluable as a foundation to build upon as I continue into my career.”

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