Radiomics based on preoperative rectal cancer MRI to predict the metachronous liver metastasis
Abdominal Radiology(2022)
Abstract
Purpose At present, there are few effective method to predict metachronous liver metastasis (MLM) from rectal cancer. We aim to investigate the efficacy of radiomics based on multiparametric MRI of first diagnosed rectal cancer in predicting MLM from rectal cancer. Methods From 301 consecutive histopathologically confirmed rectal cancer patients, 130 patients who have no distant metastasis detected at the time of diagnosis were enrolled and divided into MLM group ( n = 49) and non-MLM group ( n = 81) according to whether liver metastasis be detected later than 6 month after the first diagnosis of rectal cancer within 3 years’ follow-up. The 130 patients were divided into a training set ( n = 91) and a testing set ( n = 39) at a ratio of 7:3 by stratified sampling using SPSS 24.0 software. The DWI model, HD T 2 WI model, and DWI + HD T 2 WI model were constructed respectively. The best performing model was selected and combined with the screened clinical features (including non-radiomics MRI features) to construct a fusion model. The testing set was used to evaluate the performance of the models, and the area under the curve (AUC) of receiver operating characteristics (ROC) was calculated for both the training set and the testing set. Results The AUC of the DWI + HD T 2 WI model in the testing set was higher than that of the DWI or the HD T 2 model alone with statistically significance ( P < 0.05). The screened clinical features were extramural vascular invasion (EMVI), T and N stages in MRI ( mr T, mr N), and the distance from the lower edge of the tumor to the anal verge. The AUC of the fusion model in the testing set was 0.911. Decision curves and nomogram also showed that the fusion model had excellent clinical performance. Conclusion The fusion model of primary rectal cancer MRI based radiomics combing clinical features can effectively predict MLM from rectal cancer, which may assist clinicians in formulating individualized monitoring and treatment plans. Graphical abstract
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Key words
Rectal cancer, Metachronous liver metastasis, Magnetic resonance imaging, Radiomics
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