CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer

Abstract Background and Purpose Early detection of non‐response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced colorectal cancer (LARC) remains challenging. We aimed to assess whether pretreatment radiotherapy planning computed tomography (CT) radiomics could distinguish the patients w...

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Main Authors: Zinan Zhang, Xiaoping Yi, Qian Pei, Yan Fu, Bin Li, Haipeng Liu, Zaide Han, Changyong Chen, Peipei Pang, Huashan Lin, Guanghui Gong, Hongling Yin, Hongyan Zai, Bihong T. Chen
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Language:English
Published: Wiley 2023-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.5086
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author Zinan Zhang
Xiaoping Yi
Qian Pei
Yan Fu
Bin Li
Haipeng Liu
Zaide Han
Changyong Chen
Peipei Pang
Huashan Lin
Guanghui Gong
Hongling Yin
Hongyan Zai
Bihong T. Chen
author_facet Zinan Zhang
Xiaoping Yi
Qian Pei
Yan Fu
Bin Li
Haipeng Liu
Zaide Han
Changyong Chen
Peipei Pang
Huashan Lin
Guanghui Gong
Hongling Yin
Hongyan Zai
Bihong T. Chen
author_sort Zinan Zhang
collection DOAJ
description Abstract Background and Purpose Early detection of non‐response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced colorectal cancer (LARC) remains challenging. We aimed to assess whether pretreatment radiotherapy planning computed tomography (CT) radiomics could distinguish the patients with no response or no downstaging after nCRT from those with response and downstaging after nCRT. Materials and Methods Patients with LARC who were treated with nCRT were retrospectively enrolled between March 2009 and March 2019. Traditional radiological characteristics were analyzed by visual inspection and radiomic features were analyzed through computational methods from the pretreatment radiotherapy planning CT images. Differentiation models were constructed using radiomic methods and clinicopathological characteristics for predicting non‐response to nCRT. Model performance was assessed for classification efficiency, calibration, discrimination, and clinical application. Results This study enrolled a total of 215 patients, including 151 patients in the training cohort (50 non‐responders and 101 responders) and 64 patients in the validation cohort (21 non‐responders and 43 responders). For predicting non‐response, the model constructed with an ensemble machine learning method had higher performance with area under the curve (AUC) values of 0.92 and 0.89 as compared to the model constructed with the logistic regression method (AUC: 0.72 and 0.71 for the training and validation cohorts, respectively). Both decision curve and calibration curve analyses confirmed that the ensemble machine learning model had higher prediction performance. Conclusion Pretreatment CT radiomics achieved satisfying performance in predicting non‐response to nCRT and could be helpful to assist in treatment planning for patients with LARC.
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spelling doaj-art-9cae42001dbc408ba34e508dbdba1c3e2025-08-20T02:23:32ZengWileyCancer Medicine2045-76342023-02-011232463247310.1002/cam4.5086CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancerZinan Zhang0Xiaoping Yi1Qian Pei2Yan Fu3Bin Li4Haipeng Liu5Zaide Han6Changyong Chen7Peipei Pang8Huashan Lin9Guanghui Gong10Hongling Yin11Hongyan Zai12Bihong T. Chen13Department of Radiology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Radiology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of General Surgery (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Radiology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Oncology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Radiology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Radiology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Radiology (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Pharmaceuticals and Diagnosis GE Healthcare Changsha P.R. ChinaDepartment of Pharmaceuticals and Diagnosis GE Healthcare Changsha P.R. ChinaDepartment of Pathology, Xiangya Hospital Central South University Changsha Hunan P.R. ChinaDepartment of Pathology, Xiangya Hospital Central South University Changsha Hunan P.R. ChinaDepartment of General Surgery (Xiangya Hospital) Central South University Changsha Hunan P.R. ChinaDepartment of Diagnostic Radiology City of Hope National Medical Center Duarte California USAAbstract Background and Purpose Early detection of non‐response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced colorectal cancer (LARC) remains challenging. We aimed to assess whether pretreatment radiotherapy planning computed tomography (CT) radiomics could distinguish the patients with no response or no downstaging after nCRT from those with response and downstaging after nCRT. Materials and Methods Patients with LARC who were treated with nCRT were retrospectively enrolled between March 2009 and March 2019. Traditional radiological characteristics were analyzed by visual inspection and radiomic features were analyzed through computational methods from the pretreatment radiotherapy planning CT images. Differentiation models were constructed using radiomic methods and clinicopathological characteristics for predicting non‐response to nCRT. Model performance was assessed for classification efficiency, calibration, discrimination, and clinical application. Results This study enrolled a total of 215 patients, including 151 patients in the training cohort (50 non‐responders and 101 responders) and 64 patients in the validation cohort (21 non‐responders and 43 responders). For predicting non‐response, the model constructed with an ensemble machine learning method had higher performance with area under the curve (AUC) values of 0.92 and 0.89 as compared to the model constructed with the logistic regression method (AUC: 0.72 and 0.71 for the training and validation cohorts, respectively). Both decision curve and calibration curve analyses confirmed that the ensemble machine learning model had higher prediction performance. Conclusion Pretreatment CT radiomics achieved satisfying performance in predicting non‐response to nCRT and could be helpful to assist in treatment planning for patients with LARC.https://doi.org/10.1002/cam4.5086CT radiomicslocally advanced colorectal cancerneoadjuvant chemoradiotherapypredictionradiotherapy planningtreatment response
spellingShingle Zinan Zhang
Xiaoping Yi
Qian Pei
Yan Fu
Bin Li
Haipeng Liu
Zaide Han
Changyong Chen
Peipei Pang
Huashan Lin
Guanghui Gong
Hongling Yin
Hongyan Zai
Bihong T. Chen
CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
Cancer Medicine
CT radiomics
locally advanced colorectal cancer
neoadjuvant chemoradiotherapy
prediction
radiotherapy planning
treatment response
title CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
title_full CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
title_fullStr CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
title_full_unstemmed CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
title_short CT radiomics identifying non‐responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
title_sort ct radiomics identifying non responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer
topic CT radiomics
locally advanced colorectal cancer
neoadjuvant chemoradiotherapy
prediction
radiotherapy planning
treatment response
url https://doi.org/10.1002/cam4.5086
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