MRI-based radiomic score increased mrTRG accuracy in predicting rectal cancer response to neoadjuvant therapy Journal Article

   


Authors: Miranda, J.; Horvat, N.; Assuncao, A. N. Jr; de M. Machado, F. A.; Chakraborty, J.; Pandini, R. V.; Saraiva, S.; Nahas, C. S. R.; Nahas, S. C.; Nomura, C. H.
Article Title: MRI-based radiomic score increased mrTRG accuracy in predicting rectal cancer response to neoadjuvant therapy
Abstract: Purpose: To develop a magnetic resonance imaging (MRI)-based radiomics score, i.e., “rad-score,” and to investigate the performance of rad-score alone and combined with mrTRG in predicting pathologic complete response (pCR) in patients with locally advanced rectal cancer following neoadjuvant chemoradiation therapy. Methods: This retrospective study included consecutive patients with LARC who underwent neoadjuvant chemoradiotherapy followed by surgery from between July 2011 to November 2015. Volumes of interest of the entire tumor on baseline rectal MRI and of the tumor bed on restaging rectal MRI were manually segmented on T2-weighted images. The radiologist also provided the ymrTRG score on the restaging MRI. Radiomic score (rad-score) was calculated and optimal cut-off points for both mrTRG and rad-score to predict pCR were selected using Youden's J statistic. Results: Of 180 patients (mean age = 63 years; 60% men), 33/180 (18%) achieved pCR. High rad-score (> − 1.49) yielded an area under the curve (AUC) of 0.758, comparable to ymrTRG 1–2 which yielded an AUC of 0.759. The combination of high rad-score and ymrTRG 1–2 yielded a significantly higher AUC of 0.836 compared with ymrTRG 1–2 and high rad-score alone (p < 0.001). A logistic regression model incorporating both high rad-score and mrTRG 1–2 was built to calculate adjusted odds ratios for pCR, which was 4.85 (p < 0.001). Conclusion: Our study demonstrates that a rectal restaging MRI-based rad-score had comparable diagnostic performance to ymrTRG. Moreover, the combined rad-score and ymrTRG model yielded a significant better diagnostic performance for predicting pCR. Graphical abstract: [Figure not available: see fulltext.] © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: adult; cancer chemotherapy; controlled study; treatment outcome; treatment response; middle aged; cancer surgery; retrospective studies; major clinical study; cancer localization; fluorouracil; advanced cancer; cancer patient; cancer radiotherapy; neoadjuvant therapy; cancer staging; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer grading; tumor regression; pathology; diagnostic imaging; retrospective study; prediction; radiologist; diagnostic value; folinic acid; rectal neoplasms; rectum cancer; rectum tumor; chemoradiotherapy; rectal cancer; image segmentation; diagnostic test accuracy study; procedures; neoadjuvant chemoradiotherapy; humans; human; male; female; article; radiomics; t2 weighted imaging
Journal Title: Abdominal Radiology
Volume: 48
Issue: 6
ISSN: 2366-004X
Publisher: Springer  
Date Published: 2023-06-01
Start Page: 1911
End Page: 1920
Language: English
DOI: 10.1007/s00261-023-03898-x
PUBMED: 37004557
PROVIDER: scopus
PMCID: PMC10942660
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85151469955&doi=10.1007%2fs00261-023-03898-x&partnerID=40&md5=4059f263d19ab5ef395fa9062bb81b19
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- MSK corresponding author is Natally Horvat -- Source: Scopus
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MSK Authors
  1. Jayasree Chakraborty
    69 Chakraborty
  2. Natally Horvat
    101 Horvat
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