Abstract
Background
Locally advanced rectal cancer (LARC) is treated by neoadjuvant chemoradiotherapy(NCRT) followed by surgery after restaging by magnetic resonance imaging(MRI). Texture analysis(TA) is a novel imaging biomarker that can assess heterogeneity in MRIs. This study hypothesizes that TA has the ability to predict the complete response(CR), survival, local recurrence, and distant metastasis.
Method
This is a retrospective analysis of all patients diagnosed with LARC who received NCRT and who have had MRI scans. Six parameters were systematically extracted from Textural histograms of post-treatment scans. Correlation between TA and CR was tested. These parameters were then examined to determine their ability in predicting local recurrence, distant metastases, and survival by means of Kaplan-Meier survival curves and log-rank tests.
Results
Four out of the six parameters extracted significantly identified CR. Utilising the same cut-off values across all parameters, three parameters significantly predicted local recurrence: Entropy(p = 0.033), mean of positive pixels(MPP)(p = 0.045), and Skewness(p = 0.018). Four parameters significantly predicted distant metastases: SD(p = 0.015), entropy(p = 0.017), MPP(p = 0.005), and skewness (p < 0.001). Four texture parameters significantly predicted survival: SD(p = 0.002), entropy(p = 0.001), MPP(p < 0.001), and skewness(p = 0.017).
Conclusions
MRI textural features are potentially significant imaging biomarkers in predicting survival, local recurrence, or liver metastases in LARC.
CT texture analysis in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy: A potential imaging biomarker for treatment response and prognosis
