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

Autor: Miranda J; Department of Radiology, University of Sao Paulo, Sao Paulo, SP, Brazil., Horvat N; Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, Box 29, New York, NY, 10065, USA. natallymhorvat@gmail.com., Assuncao AN Jr; Department of Radiology, University of Sao Paulo, Sao Paulo, SP, Brazil.; Research and Education Institute, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil., de M Machado FA; Research and Education Institute, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil., Chakraborty J; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Pandini RV; Department of Surgery, University of Sao Paulo, Sao Paulo, SP, Brazil., Saraiva S; Department of Radiology, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil., Nahas CSR; Department of Surgery, University of Sao Paulo, Sao Paulo, SP, Brazil., Nahas SC; Department of Surgery, University of Sao Paulo, Sao Paulo, SP, Brazil., Nomura CH; Department of Radiology, University of Sao Paulo, Sao Paulo, SP, Brazil.; Department of Radiology, Hospital Sirio-Libanes, Sao Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: Abdominal radiology (New York) [Abdom Radiol (NY)] 2023 Jun; Vol. 48 (6), pp. 1911-1920. Date of Electronic Publication: 2023 Apr 01.
DOI: 10.1007/s00261-023-03898-x
Abstrakt: 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.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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