Affiliation:
1. The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University
2. Sun Yat-sen University Cancer Center
3. Meizhou People's Hospital
4. Huazhong University of Science and Technology Union Shenzhen Hospital
5. International Cancer Center, Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy, Shenzhen University Health Science Center
Abstract
Abstract
Background: To develop and validate radiomic models for prediction of tumor response to neoadjuvant therapy (NAT) in patients with locally advanced rectal cancer (LARC) using both pre-NAT and post-NAT multiparameter magnetic resonance imaging (mpMRI).
Methods: In this multicenter study, a total of 563 patients were included from two independent centers. 453 patients from center 1 were split into training and testing cohorts, the remaining 110 from center 2 served as an external validation cohort. Pre-NAT and post-NAT mpMRI was collected for feature extraction. The radiomic models were constructed using machine learning from a training cohort. The accuracy of the models was verified in a testing cohort and an independent external validation cohort. Model performance was evaluated using area under the curve (AUC), sensitivity, specificity, positive predictive value, and negative predictive value.
Results: The model constructed with pre-NAT mpMRI had favorable accuracy for prediction of non-response to NAT in the training cohort (AUC = 0.84), testing cohort (AUC = 0.81), and external validation cohort (AUC = 0.79), which outperformed single-sequence MRI. The model constructed with both pre-NAT and post-NAT mpMRI had powerful diagnostic value for pathologic complete response (pCR) in the training cohort (AUC = 0.86), testing cohort (AUC = 0.87), and external validation cohort (AUC = 0.87), which outperformed single-phase mpMRI and MR tumor regression grade for identification of pCR.
Conclusions: Models constructed with multiphase and multiparameter MRI were able to predict tumor response to NAT with high accuracy and robustness, which may assist in individualized management of LARC.
Publisher
Research Square Platform LLC