MR imaging of rectal cancer: Radiomics analysis to assess treatment response after neoadjuvant therapy Journal Article


Authors: Horvat, N.; Veeraraghavan, H.; Khan, M.; Blazic, I.; Zheng, J.; Capanu, M.; Sala, E.; Garcia-Aguilar, J.; Gollub, M. J.; Petkovska, I.
Article Title: MR imaging of rectal cancer: Radiomics analysis to assess treatment response after neoadjuvant therapy
Abstract: Purpose: To investigate the value of T2-weighted–based radiomics compared with qualitative assessment at T2-weighted imaging and diffusion-weighted (DW) imaging for diagnosis of clinical complete response in patients with rectal cancer after neoadjuvant chemotherapy–radiation therapy (CRT). Materials and This retrospective study included 114 patients with rectal Methods: cancer who underwent magnetic resonance (MR) imaging after CRT between March 2012 and February 2016. Median age among women (47 of 114, 41%) was 55.9 years (interquartile range, 45.4–66.7 years) and median age among men (67 of 114, 59%) was 55 years (interquartile range, 48–67 years). Surgical histopathologic analysis was the reference standard for pathologic complete response (pCR). For qualitative assessment, two radiologists reached a consensus. For radiomics, one radiologist segmented the volume of interest on high-spatial-resolution T2-weighted images. A random forest classifier was trained to separate the patients by their outcomes after balancing the number of patients in each response category by using the synthetic minority oversampling technique. Statistical analysis was performed by using the Wilcoxon rank-sum test, McNemar test, and Benjamini-Hochberg method. Results: Twenty-one of 114 patients (18%) achieved pCR. The radiomic classifier demonstrated an area under the curve of 0.93 (95% confidence interval [CI]: 0.87, 0.96), sensitivity of 100% (95% CI: 0.84, 1), specificity of 91% (95% CI: 0.84, 0.96), positive predictive value of 72% (95% CI: 0.53, 0.87), and negative predictive value of 100% (95% CI: 0.96, 1). The diagnostic performance of radiomics was significantly higher than was qualitative assessment at T2-weighted imaging or DW imaging alone (P , .02). The specificity and positive predictive values were significantly higher in radiomics than were at combined T2-weighted and DW imaging (P , .0001). Conclusion: T2-weighted–based radiomics showed better classification performance compared with qualitative assessment at T2-weighted and DW imaging for diagnosing pCR in patients with locally advanced rectal cancer after CRT. © RSNA, 2018.
Journal Title: Radiology
Volume: 287
Issue: 3
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2018-06-01
Start Page: 833
End Page: 843
Language: English
DOI: 10.1148/radiol.2018172300
PROVIDER: scopus
PMCID: PMC5978457
PUBMED: 29514017
DOI/URL:
Notes: Review -- Export Date: 2 July 2018 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Junting Zheng
    200 Zheng
  2. Evis Sala
    113 Sala
  3. Marc J Gollub
    209 Gollub
  4. Marinela Capanu
    388 Capanu
  5. Ivana   Blazic
    5 Blazic
  6. Natally Horvat
    103 Horvat
  7. Monika Khan
    3 Khan