MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis

PurposeTo evaluate the value of MRI-based radiomics for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC) through a systematic review and meta-analysis.MethodsA systematic literature search was conducted...

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Main Authors: Zhongfan Liao, Dashuang Luo, Xiaoyan Tang, Fasheng Huang, Xuhui Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1550838/full
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author Zhongfan Liao
Dashuang Luo
Xiaoyan Tang
Fasheng Huang
Xuhui Zhang
author_facet Zhongfan Liao
Dashuang Luo
Xiaoyan Tang
Fasheng Huang
Xuhui Zhang
author_sort Zhongfan Liao
collection DOAJ
description PurposeTo evaluate the value of MRI-based radiomics for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC) through a systematic review and meta-analysis.MethodsA systematic literature search was conducted in PubMed, Embase, Proquest, Cochrane Library, and Web of Science databases, covering studies up to July 1st, 2024, on the diagnostic accuracy of MRI radiomics for predicting pCR in LARC patients following NCRT. Two researchers independently evaluated and selected studies using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool and the Radiomics Quality Score (RQS) tool. A random-effects model was employed to calculate the pooled sensitivity, specificity, and diagnostic odds ratio (DOR) for MRI radiomics in predicting pCR. Meta-regression and subgroup analyses were performed to explore potential sources of heterogeneity. Statistical analyses were performed using RevMan 5.4, Stata 17.0, and Meta-Disc 1.4.ResultsA total of 35 studies involving 9,696 LARC patients were included in this meta-analysis. The average RQS score of the included studies was 13.91 (range 9.00-24.00), accounting for 38.64% of the total score. According to QUADAS-2, there were risks of bias in patient selection and flow and timing domain, though the overall quality of the studies was acceptable. MRI-based radiomics showed no significant threshold effect in predicting pCR (Spearman correlation coefficient=0.119, P=0.498) but exhibited high heterogeneity (I2≥50%). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and DOR were 0.83, 0.82, 5.1, 0.23 and 27.22 respectively, with an area under the summary receiver operating characteristic (sROC) curve of 0.91. According to joint model analysis, publication year, country, multi-magnetic field strength, multi-MRI sequence, ROI structure, contour consistency, feature extraction software, and feature quantity after feature dimensionality reduction were potential sources of heterogeneity. Deeks’ funnel plot suggested no significant publication bias (P=0.69).ConclusionsMRI-based radiomics demonstrates high efficacy for predicting pCR in LARC patients following NCRT, holding significant promise for informing clinical decision-making processes and advancing individualized treatment in rectal cancer patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024611733.
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spelling doaj-art-8ddedd303b284e3c8a6cd8c0dd82ef932025-08-20T02:47:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011510.3389/fonc.2025.15508381550838MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysisZhongfan LiaoDashuang LuoXiaoyan TangFasheng HuangXuhui ZhangPurposeTo evaluate the value of MRI-based radiomics for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer (LARC) through a systematic review and meta-analysis.MethodsA systematic literature search was conducted in PubMed, Embase, Proquest, Cochrane Library, and Web of Science databases, covering studies up to July 1st, 2024, on the diagnostic accuracy of MRI radiomics for predicting pCR in LARC patients following NCRT. Two researchers independently evaluated and selected studies using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool and the Radiomics Quality Score (RQS) tool. A random-effects model was employed to calculate the pooled sensitivity, specificity, and diagnostic odds ratio (DOR) for MRI radiomics in predicting pCR. Meta-regression and subgroup analyses were performed to explore potential sources of heterogeneity. Statistical analyses were performed using RevMan 5.4, Stata 17.0, and Meta-Disc 1.4.ResultsA total of 35 studies involving 9,696 LARC patients were included in this meta-analysis. The average RQS score of the included studies was 13.91 (range 9.00-24.00), accounting for 38.64% of the total score. According to QUADAS-2, there were risks of bias in patient selection and flow and timing domain, though the overall quality of the studies was acceptable. MRI-based radiomics showed no significant threshold effect in predicting pCR (Spearman correlation coefficient=0.119, P=0.498) but exhibited high heterogeneity (I2≥50%). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and DOR were 0.83, 0.82, 5.1, 0.23 and 27.22 respectively, with an area under the summary receiver operating characteristic (sROC) curve of 0.91. According to joint model analysis, publication year, country, multi-magnetic field strength, multi-MRI sequence, ROI structure, contour consistency, feature extraction software, and feature quantity after feature dimensionality reduction were potential sources of heterogeneity. Deeks’ funnel plot suggested no significant publication bias (P=0.69).ConclusionsMRI-based radiomics demonstrates high efficacy for predicting pCR in LARC patients following NCRT, holding significant promise for informing clinical decision-making processes and advancing individualized treatment in rectal cancer patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024611733.https://www.frontiersin.org/articles/10.3389/fonc.2025.1550838/fullmagnetic resonance imagingradiomicsrectal neoplasmsneoadjuvant chemoradiotherapymeta-analysis
spellingShingle Zhongfan Liao
Dashuang Luo
Xiaoyan Tang
Fasheng Huang
Xuhui Zhang
MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis
Frontiers in Oncology
magnetic resonance imaging
radiomics
rectal neoplasms
neoadjuvant chemoradiotherapy
meta-analysis
title MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis
title_full MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis
title_fullStr MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis
title_full_unstemmed MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis
title_short MRI-based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis
title_sort mri based radiomics for predicting pathological complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer a systematic review and meta analysis
topic magnetic resonance imaging
radiomics
rectal neoplasms
neoadjuvant chemoradiotherapy
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1550838/full
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