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Pre-Treatment T2-WI Based Radiomics Features for Prediction of Locally Advanced Rectal Cancer Non-Response to Neoadjuvant Chemoradiotherapy: A Preliminary Study
Article

Radiomic Texture and Shape Descriptors of the Rectal Environment on Post-Chemoradiation T2-Weighted MRI are Associated with Pathologic Tumor Stage Regression in Rectal Cancers: A Retrospective, Multi-Institution Study

1
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
2
Computer Imaging and Medical Application Laboratory, Universidad Nacional de Colombia, Bogotá 111321, Colombia
3
Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Department of General Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
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Department of Abdominal Imaging, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
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Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA
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Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH 44106, USA
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Section of Abdominal Imaging and Nuclear Radiology Department, Cleveland Clinic, Cleveland, OH 44195, USA
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Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
10
Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Cancers 2020, 12(8), 2027; https://doi.org/10.3390/cancers12082027
Received: 1 May 2020 / Revised: 29 June 2020 / Accepted: 3 July 2020 / Published: 24 July 2020
(This article belongs to the Special Issue Radiomics and Cancers)

(1) Background: The relatively poor expert restaging accuracy of MRI in rectal cancer after neoadjuvant chemoradiation may be due to the difficulties in visual assessment of residual tumor on post-treatment MRI. In order to capture underlying tissue alterations and morphologic changes in rectal structures occurring due to the treatment, we hypothesized that radiomics texture and shape descriptors of the rectal environment (e.g., wall, lumen) on post-chemoradiation T2-weighted (T2w) MRI may be associated with tumor regression after neoadjuvant chemoradiation therapy (nCRT). (2) Methods: A total of 94 rectal cancer patients were retrospectively identified from three collaborating institutions, for whom a 1.5 or 3T T2w MRI was available after nCRT and prior to surgical resection. The rectal wall and the lumen were annotated by an expert radiologist on all MRIs, based on which 191 texture descriptors and 198 shape descriptors were extracted for each patient. (3) Results: Top-ranked features associated with pathologic tumor-stage regression were identified via cross-validation on a discovery set (n = 52, 1 institution) and evaluated via discriminant analysis in hold-out validation (n = 42, 2 institutions). The best performing features for distinguishing low (ypT0-2) and high (ypT3–4) pathologic tumor stages after nCRT comprised directional gradient texture expression and morphologic shape differences in the entire rectal wall and lumen. Not only were these radiomic features found to be resilient to variations in magnetic field strength and expert segmentations, a quadratic discriminant model combining them yielded consistent performance across multiple institutions (hold-out AUC of 0.73). (4) Conclusions: Radiomic texture and shape descriptors of the rectal wall from post-treatment T2w MRIs may be associated with low and high pathologic tumor stage after neoadjuvant chemoradiation therapy and generalized across variations between scanners and institutions. View Full-Text
Keywords: radiomics; rectal cancer; texture; shape; magnetic resonance imaging; treatment response; machine learning radiomics; rectal cancer; texture; shape; magnetic resonance imaging; treatment response; machine learning
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MDPI and ACS Style

Alvarez-Jimenez, C.; Antunes, J.T.; Talasila, N.; Bera, K.; Brady, J.T.; Gollamudi, J.; Marderstein, E.; Kalady, M.F.; Purysko, A.; Willis, J.E.; Stein, S.; Friedman, K.; Paspulati, R.; Delaney, C.P.; Romero, E.; Madabhushi, A.; Viswanath, S.E. Radiomic Texture and Shape Descriptors of the Rectal Environment on Post-Chemoradiation T2-Weighted MRI are Associated with Pathologic Tumor Stage Regression in Rectal Cancers: A Retrospective, Multi-Institution Study. Cancers 2020, 12, 2027. https://doi.org/10.3390/cancers12082027

AMA Style

Alvarez-Jimenez C, Antunes JT, Talasila N, Bera K, Brady JT, Gollamudi J, Marderstein E, Kalady MF, Purysko A, Willis JE, Stein S, Friedman K, Paspulati R, Delaney CP, Romero E, Madabhushi A, Viswanath SE. Radiomic Texture and Shape Descriptors of the Rectal Environment on Post-Chemoradiation T2-Weighted MRI are Associated with Pathologic Tumor Stage Regression in Rectal Cancers: A Retrospective, Multi-Institution Study. Cancers. 2020; 12(8):2027. https://doi.org/10.3390/cancers12082027

Chicago/Turabian Style

Alvarez-Jimenez, Charlems, Jacob T. Antunes, Nitya Talasila, Kaustav Bera, Justin T. Brady, Jayakrishna Gollamudi, Eric Marderstein, Matthew F. Kalady, Andrei Purysko, Joseph E. Willis, Sharon Stein, Kenneth Friedman, Rajmohan Paspulati, Conor P. Delaney, Eduardo Romero, Anant Madabhushi, and Satish E. Viswanath. 2020. "Radiomic Texture and Shape Descriptors of the Rectal Environment on Post-Chemoradiation T2-Weighted MRI are Associated with Pathologic Tumor Stage Regression in Rectal Cancers: A Retrospective, Multi-Institution Study" Cancers 12, no. 8: 2027. https://doi.org/10.3390/cancers12082027

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