Evaluation of Neoadjuvant Chemoradiotherapy Response in Rectal Cancer Using MR Images and Deep Learning Neural Networks.

Autor:	Cingoz E; Department of Radiology, Bagcilar Training and Research Hospital, Istanbul, Turkey., Ertas G; Department of Biomedical Engineering, Yeditepe University, Istanbul, Turkey., Kaval G; Department of Radiation Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Azamat S; Department of Radiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey., Karaman S; Department of Radiation Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Kulle CB; Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Berker N; Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Cingöz M; Department of Radiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey., Dagoglu Sakin N; Department of Radiation Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Comert RG; Department of Radiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Buyuk M; Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey., Kartal MGD; Department of Radiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Current medical imaging [Curr Med Imaging] 2024; Vol. 20, pp. e15734056309748.
DOI:	10.2174/0115734056309748240509072222
Abstrakt:	Introduction: The aim of the study was to develop deep-learning neural networks to guide treatment decisions and for the accurate evaluation of tumor response to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer using magnetic resonance (MR) images. Methods: Fifty-nine tumors with stage 2 or 3 rectal cancer that received nCRT were retrospectively evaluated. Pathological tumor regression grading was carried out using the Dworak (Dw-TRG) guidelines and served as the ground truth for response predictions. Imaging-based tumor regression grading was performed according to the MERCURY group guidelines from pre-treatment and post-treatment para-axial T2-weighted MR images (MR-TRG). Tumor signal intensity signatures were extracted by segmenting the tumors volumetrically on the images. Normalized histograms of the signatures were used as input to a deep neural network (DNN) housing long short-term memory (LSTM) units. The output of the network was the tumor regression grading prediction, DNN-TRG. Results: In predicting complete or good response, DNN-TRG demonstrated modest agreement with Dw-TRG (Cohen's kappa= 0.79) and achieved 84.6% sensitivity, 93.9% specificity, and 89.8% accuracy. MR-TRG revealed 46.2% sensitivity, 100% specificity, and 76.3% accuracy. In predicting a complete response, DNN-TRG showed slight agreement with Dw-TRG (Cohen's kappa= 0.75) with 71.4% sensitivity, 97.8% specificity, and 91.5% accuracy. MR-TRG provided 42.9% sensitivity, 100% specificity, and 86.4% accuracy. DNN-TRG benefited from higher sensitivity but lower specificity, leading to higher accuracy than MR-TRG in predicting tumor response. Conclusion: The use of deep LSTM neural networks is a promising approach for evaluating the tumor response to nCRT in rectal cancer.
Databáze:	MEDLINE
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