MRI T2-weighted sequences-based texture analysis (TA) as a predictor of response to neoadjuvant chemo-radiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC)
MRI T2-weighted sequences-based texture analysis (TA) as a predictor of response to neoadjuvant chemo-radiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC)
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DOI：
10.1007/s11547-020-01215-w
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发表时间：
2020-05-14
影响因子：
8.9
通讯作者：
Stramare, Roberto
中科院分区：
文献类型：
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作者：
Crimi, Filippo;Capelli, Giulia;Stramare, Roberto
目的探讨MRI T2加权序列纹理分析（TA）能否预测局部进展期直肠癌（LARC）新辅助放化疗（nCRT）患者的组织病理学肿瘤消退分级（TRG）。方法收集接受LARC根治性手术的患者资料。根据Mandard系统，具有完全病理学反应或TRG 1的患者被归类为反应者，而TRG >= 2的患者被归类为无反应者。在nCRT前后扫描中对每例患者的旁轴T2 w MRI进行肿瘤TA，以提取直方图、灰度共生矩阵（GLCM）和游程矩阵（RLM）纹理参数。对于两组之间显示出显著差异的特征，绘制受试者工作特征（ROC）曲线。结果总体而言，确定了2013年至2019年期间在我们机构接受nCRT和切除手术治疗的62例LARC患者。仅nCRT后GLCM最大概率显示两组之间存在显著差异（应答者为2909 +/- 4479，无应答者为6515 +/- 8990; p = 0.039）;在ROC曲线上，Youden指数显示该参数的灵敏度为14%，特异性为100%。结论基于MRI T2加权序列的TA不能有效预测LARC患者对nCRT的病理完全缓解。需要进一步的研究来彻底调查MRI TA在这种情况下的潜力。
Purpose To determine whether MRI T2-weighted sequences-based texture analysis (TA) can predict histopathological tumor regression grade (TRG) in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemo-radiotherapy (nCRT). Methods Data on patients undergoing curative-intent surgery for LARC were collected. Patients with a complete pathological response, or TRG1 according to Mandard's system were classified as responders, while patients with TRG >= 2 were classified as non-responders. Tumor TA was performed on each patient's paraxial T2w MRI in both pre- and post-nCRT scans, in order to extract histograms, gray-level co-occurrence matrix (GLCM) and run-length matrix (RLM) texture parameters. For features that showed a significant difference between the two groups, a receiver operating characteristic (ROC) curve was drawn. Results Overall, 62 patients with LARC, treated with nCRT and resective surgery at our institution between 2013 and 2019 were identified. Only post-nCRT GLCM maximum probability showed a significant difference between the two groups (2909 +/- 4479 in responders vs. 6515 +/- 8990 in non- responders; p = 0.039); at the ROC curve, Youden index showed a sensitivity of 14% and a specificity of 100% for this parameter. Conclusions MRI T2-weighted sequences-based TA was not effective in predicting pathological complete response to nCRT in patients with LARC. Further studies are needed to thoroughly investigate the potential of MRI TA in this setting.