Title
Do We Need Complex Image Features to Personalize Treatment of Patients with Locally Advanced Rectal Cancer?
Abstract
Radiomics has shown great potential for outcome prognosis and presents a promising approach for improving personalized cancer treatment. In radiomic analyses, features of different complexity are extracted from clinical imaging datasets, which are correlated to the endpoints of interest using machine-learning approaches. However, it is generally unclear if more complex features have a higher prognostic value and show a robust performance in external validation. Therefore, in this study, we developed and validated radiomic signatures for outcome prognosis after neoadjuvant radiochemotherapy in locally advanced rectal cancer (LARC) using computed tomography (CT) and T2-weighted magnetic resonance imaging (MRI) of two independent institutions (training/validation: 94/28 patients). For the prognosis of tumor response and freedom from distant metastases (FFDM), we used different imaging features extracted from the gross tumor volume: less complex morphological and first-order (MFO) features, more complex second-order texture (SOT) features, and both feature classes combined. Analyses were performed for both imaging modalities separately and combined. Performance was assessed by the area under the curve (AUC) and the concordance index (CI) for tumor response and FFDM, respectively. Overall, radiomic features showed prognostic value for both endpoints. Combining MFO and SOT features led to equal or higher performance in external validation compared to MFO and SOT features alone. The best results were observed after combining MRI and CT features (AUC = 0.76, CI = 0.65). In conclusion, promising biomarker signatures combining MRI and CT were developed for outcome prognosis in LARC. Further external validation is pending before potential clinical application.
Year
DOI
Venue
2021
10.1007/978-3-030-87234-2_73
MEDICAL IMAGE COMPUTING AND COMPUTER ASSISTED INTERVENTION - MICCAI 2021, PT VII
Keywords
DocType
Volume
Rectal cancer, Tumor response, Distant metastases, Biomarkers
Conference
12907
ISSN
Citations 
PageRank 
0302-9743
0
0.34
References 
Authors
0
11