Affiliation:
1. Department of Gastrointestinal Surgery Affiliated Hospital of Qingdao University Qingdao China
2. Department of Gastrointestinal Surgery The Second Affiliated Hospital of Shandong First Medical University Shandong China
3. College of Control Science and Technology Shandong University Shandong China
4. Department of Gastrointestinal Surgery Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery Affiliated Hospital of Qingdao University Qingdao China
Abstract
AbstractObjectivesA circumferential resection margin (CRM) is an independent risk factor for local recurrence, distant metastasis, and poor overall survival of rectal cancer. In this study, we developed and validated a radiomics prediction model to predict perioperative surgical margins in patients with middle and low rectal cancer following neoadjuvant treatment and for decisions about treatment plans for patients.MethodsThis study retrospectively analyzed 275 patients from center 1(training cohort) and 120 patients from center 2(verification cohort) with rectal cancer diagnosed at two centers from July 2020 to July 2022 who underwent neoadjuvant therapy and had their CRM status confirmed by preoperative high‐resolution magnetic resonance imaging (MRI) scans. Radiomics signatures were extracted and screened from MRI images and a radiomics signature was built by the least absolute shrinkage and selection operator (LASSO) logistic regression model, which was combined with clinical signatures to construct a nomogram. The receiver operating characteristic (ROC) curve and area under the curve (AUC) value, sensitivity, specificity, positive predictive value, negative predictive value, and calibration curve were used to evaluate the predictive performance of the model.ResultsIn our research, the combined model has the best performance. In the training group, the radiomics model based on high‐spatial‐resolution T2‐weighted imaging (HR‐T2WI), clinical model and combined model demonstrated an AUC of 0.819 (0.802–0.833), 0.843 (0.822–0.861), and 0.910 (0.880‐0.940), respectively. In the validation group, they demonstrated an AUC of 0.745 (0.715–0.788), 0.827 (0.798–0.850), and 0.848 (0.779‐0.917), respectively. The calibration curve confirmed the clinical applicability of the model.ConclusionsThe individualized prediction model established by combining radiomics signatures and clinical signatures can efficiently and objectively predict perioperative margin invasion in patients with middle and low rectal cancer.