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Multicenter Study
. 2020 Mar;45(3):632-643.
doi: 10.1007/s00261-019-02321-8.

Radiomics performs comparable to morphologic assessment by expert radiologists for prediction of response to neoadjuvant chemoradiotherapy on baseline staging MRI in rectal cancer

Joost J M van Griethuysen  1   2 , Doenja M J Lambregts  3 , Stefano Trebeschi  1   2 , Max J Lahaye  1 , Frans C H Bakers  4 , Roy F A Vliegen  5 , Geerard L Beets  2   6 , Hugo J W L Aerts  2   7 , Regina G H Beets-Tan  1   2
Affiliations
Multicenter Study

Radiomics performs comparable to morphologic assessment by expert radiologists for prediction of response to neoadjuvant chemoradiotherapy on baseline staging MRI in rectal cancer

Joost J M van Griethuysen et al. Abdom Radiol (NY). 2020 Mar.

Abstract

Purpose: To compare the performance of advanced radiomics analysis to morphological assessment by expert radiologists to predict a good or complete response to chemoradiotherapy in rectal cancer using baseline staging MRI.

Materials and methods: We retrospectively assessed the primary staging MRIs [prior to chemoradiotherapy (CRT)] of 133 rectal cancer patients from 2 centers. First, two expert radiologists subjectively estimated the likelihood of achieving a "complete response" (ypT0) and "good response" (TRG 1-2), using a 5-point score (based on TN-stage, MRF/EMVI-status, size/signal/shape). Next, tumor volumes were segmented on high b value DWI (semi-automated, corrected by 2 non-expert and 2-expert readers, resulting in 5 segmentations), copied to the remaining sequences after which a total of 2505 radiomic features were extracted from T2W, low and high b value DWI and ADC. Stability of features for noise due to inter-reader and inter-scanner and protocol variations was assessed using intraclass correlation (ICC) and the Kruskal-Wallis test. Using data from center 1 (n = 86; training set), top 9 features were selected using minimum Redundancy Maximum Relevance and combined in a logistic regression model. Finally, diagnostic performance of the fitted models was assessed on data from center 2 (n = 47; validation set) and compared to the performance of the radiologists.

Results: The Radiomic models resulted in AUCs of 0.69-0.79 (with similar results for the segmentations performed by expert/non-expert readers) to predict response, results similar to the morphologic prediction by the expert radiologists (AUC 0.67-0.83). Radiomics using semi-automatically generated segmentations (without manual input) did not result in significant predictive performance.

Conclusions: Radiomics could predict response to therapy with comparable diagnostic performance as expert radiologists, regardless of whether image segmentation was performed by non-expert or expert readers, indicating that expert input is not required in order for the radiomics workflow to produce significant predictive performance.

Keywords: Magnetic resonance imaging; Radiomics; Rectal cancer; Response prediction; Texture analysis.

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References

    1. Maas M, Beets-Tan RG, Lambregts DM, Lammering G, Nelemans PJ, Engelen SM, et al. (2011) Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer. J Clin Oncol 29:4633–40. https://doi.org/10.1200/jco.2011.37.7176 . - DOI
    1. Martens MH, Maas M, Heijnen LA, Lambregts DMJ, Leijtens JWA, Stassen LPS, et al. (2016) Long-term Outcome of an Organ Preservation Program After Neoadjuvant Treatment for Rectal Cancer. J Natl Cancer Inst 108:djw171. https://doi.org/10.1093/jnci/djw171 . - DOI
    1. van der Valk MJM, Hilling DE, Bastiaannet E, Meershoek-Klein Kranenbarg E, Beets GL, Figueiredo NL, et al. (2018) Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet 391:2537–45. https://doi.org/10.1016/s0140-6736(18)31078-x . - DOI
    1. Verseveld M, De Graaf EJR, Verhoef C, van Meerten E, Punt CJA, de Hingh IHJT, et al. (2015) Chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery (CARTS study). Br J Surg 102:853–60. https://doi.org/10.1002/bjs.9809 . - DOI
    1. Bujko K, Richter P, Smith FM, Polkowski W, Szczepkowski M, Rutkowski A, et al. (2013) Preoperative radiotherapy and local excision of rectal cancer with immediate radical re-operation for poor responders: a prospective multicentre study. Radiother Oncol 106:198–205. https://doi.org/10.1016/j.radonc.2012.12.005 . - DOI

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