MRI-based radiomics to predict response in locally advanced rectal cancer: comparison of manual and automatic segmentation on external validation in a multicentre study.

Artificial intelligence Machine learning Multiparametric magnetic resonance imaging Neoadjuvant therapy Rectal neoplasms

Journal

European radiology experimental
ISSN: 2509-9280
Titre abrégé: Eur Radiol Exp
Pays: England
ID NLM: 101721752

Informations de publication

Date de publication:
03 05 2022
Historique:
received: 14 12 2021
accepted: 23 03 2022
entrez: 2 5 2022
pubmed: 3 5 2022
medline: 6 5 2022
Statut: epublish

Résumé

Pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC) is achieved in 15-30% of cases. Our aim was to implement and externally validate a magnetic resonance imaging (MRI)-based radiomics pipeline to predict response to treatment and to investigate the impact of manual and automatic segmentations on the radiomics models. Ninety-five patients with stage II/III LARC who underwent multiparametric MRI before chemoradiotherapy and surgical treatment were enrolled from three institutions. Patients were classified as responders if tumour regression grade was 1 or 2 and nonresponders otherwise. Sixty-seven patients composed the construction dataset, while 28 the external validation. Tumour volumes were manually and automatically segmented using a U-net algorithm. Three approaches for feature selection were tested and combined with four machine learning classifiers. Using manual segmentation, the best result reached an accuracy of 68% on the validation set, with sensitivity 60%, specificity 77%, negative predictive value (NPV) 63%, and positive predictive value (PPV) 75%. The automatic segmentation achieved an accuracy of 75% on the validation set, with sensitivity 80%, specificity 69%, and both NPV and PPV 75%. Sensitivity and NPV on the validation set were significantly higher (p = 0.047) for the automatic versus manual segmentation. Our study showed that radiomics models can pave the way to help clinicians in the prediction of tumour response to chemoradiotherapy of LARC and to personalise per-patient treatment. The results from the external validation dataset are promising for further research into radiomics approaches using both manual and automatic segmentations.

Sections du résumé

BACKGROUND
Pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC) is achieved in 15-30% of cases. Our aim was to implement and externally validate a magnetic resonance imaging (MRI)-based radiomics pipeline to predict response to treatment and to investigate the impact of manual and automatic segmentations on the radiomics models.
METHODS
Ninety-five patients with stage II/III LARC who underwent multiparametric MRI before chemoradiotherapy and surgical treatment were enrolled from three institutions. Patients were classified as responders if tumour regression grade was 1 or 2 and nonresponders otherwise. Sixty-seven patients composed the construction dataset, while 28 the external validation. Tumour volumes were manually and automatically segmented using a U-net algorithm. Three approaches for feature selection were tested and combined with four machine learning classifiers.
RESULTS
Using manual segmentation, the best result reached an accuracy of 68% on the validation set, with sensitivity 60%, specificity 77%, negative predictive value (NPV) 63%, and positive predictive value (PPV) 75%. The automatic segmentation achieved an accuracy of 75% on the validation set, with sensitivity 80%, specificity 69%, and both NPV and PPV 75%. Sensitivity and NPV on the validation set were significantly higher (p = 0.047) for the automatic versus manual segmentation.
CONCLUSION
Our study showed that radiomics models can pave the way to help clinicians in the prediction of tumour response to chemoradiotherapy of LARC and to personalise per-patient treatment. The results from the external validation dataset are promising for further research into radiomics approaches using both manual and automatic segmentations.

Identifiants

pubmed: 35501512
doi: 10.1186/s41747-022-00272-2
pii: 10.1186/s41747-022-00272-2
pmc: PMC9061921
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

19

Informations de copyright

© 2022. The Author(s) under exclusive licence to European Society of Radiology.

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Auteurs

Arianna Defeudis (A)

Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy. arianna.defeudis@unito.it.
Department of Surgical Sciences, University of Turin, Turin, Italy. arianna.defeudis@unito.it.
Radiology Unit, SS Annunziata Savigliano Hospital, Cuneo, Italy. arianna.defeudis@unito.it.

Simone Mazzetti (S)

Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
Department of Surgical Sciences, University of Turin, Turin, Italy.

Jovana Panic (J)

Department of Surgical Sciences, University of Turin, Turin, Italy.
Politecnico di Torino, Electronic and Telecommunication Department (DET), Turin, Italy.

Monica Micilotta (M)

Mauriziano hospital, Turin, Italy.

Lorenzo Vassallo (L)

Radiology Unit, Department of Surgical Sciences, University of Turin, Turin, Italy.

Giuliana Giannetto (G)

Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
Department of Surgical Sciences, University of Turin, Turin, Italy.

Marco Gatti (M)

Radiology Unit, Department of Surgical Sciences, University of Turin, Turin, Italy.

Riccardo Faletti (R)

Radiology Unit, Department of Surgical Sciences, University of Turin, Turin, Italy.

Stefano Cirillo (S)

Mauriziano hospital, Turin, Italy.

Daniele Regge (D)

Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
Department of Surgical Sciences, University of Turin, Turin, Italy.

Valentina Giannini (V)

Department of Radiology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy.
Department of Surgical Sciences, University of Turin, Turin, Italy.

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