Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation

Background. We hypothesized that texture analysis (TA) from the preoperative MRI can predict early disease progression (ePD), defined as the percentage of patients who relapsed or showed distant metastasis within three months from the radical surgery, in patients with locally advanced rectal cancer...

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Main Authors: Valerio Nardone, Alfonso Reginelli, Fernando Scala, Salvatore Francesco Carbone, Maria Antonietta Mazzei, Lucio Sebaste, Tommaso Carfagno, Giuseppe Battaglia, Pierpaolo Pastina, Pierpaolo Correale, Paolo Tini, Gianluca Pellino, Salvatore Cappabianca, Luigi Pirtoli
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2019/8505798
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author Valerio Nardone
Alfonso Reginelli
Fernando Scala
Salvatore Francesco Carbone
Maria Antonietta Mazzei
Lucio Sebaste
Tommaso Carfagno
Giuseppe Battaglia
Pierpaolo Pastina
Pierpaolo Correale
Paolo Tini
Gianluca Pellino
Salvatore Cappabianca
Luigi Pirtoli
author_facet Valerio Nardone
Alfonso Reginelli
Fernando Scala
Salvatore Francesco Carbone
Maria Antonietta Mazzei
Lucio Sebaste
Tommaso Carfagno
Giuseppe Battaglia
Pierpaolo Pastina
Pierpaolo Correale
Paolo Tini
Gianluca Pellino
Salvatore Cappabianca
Luigi Pirtoli
author_sort Valerio Nardone
collection DOAJ
description Background. We hypothesized that texture analysis (TA) from the preoperative MRI can predict early disease progression (ePD), defined as the percentage of patients who relapsed or showed distant metastasis within three months from the radical surgery, in patients with locally advanced rectal cancer (LARC, stage II and III, AJCC) undergoing neoadjuvant chemoradiotherapy (C-RT). Methods. This retrospective monoinstitutional cohort study included 49 consecutive patients in total with a newly diagnosed rectal cancer. All the patients underwent baseline abdominal MRI and CT scan of the chest and abdomen to exclude distant metastasis before C-RT. Texture parameters were extracted from MRI performed before C-RT (T1, DWI, and ADC sequences) using LifeX Software, a dedicated software for extracting texture parameters from radiological imaging. We divided the cohort in a training set of 34 patients and a validation set of 15 patients, and we tested the data sets for homogeneity, considering the clinical variables. Then we performed univariate and multivariate analysis, and a ROC curve was also generated. Results. Thirteen patients (26.5%) showed an ePD, three of whom with lung metastases and ten with liver relapse. The model was validated based on the prediction accuracy calculated in a previously unseen set of 15 patients. The prediction accuracy of the generated model was 82% (AUC=0.853) in the training and 80% (AUC=0.833) in the validation cohort. The only significant features at multivariate analysis was DWI GLCM Correlation (OR: 0.239, p<0.001). Conclusion. Our results suggest that TA could be useful to identify patients that may develop early progression.
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spelling doaj-art-c2eddc4e5fb04b6db213d92c54ed92c62025-08-20T02:19:02ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/85057988505798Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant ChemoradiationValerio Nardone0Alfonso Reginelli1Fernando Scala2Salvatore Francesco Carbone3Maria Antonietta Mazzei4Lucio Sebaste5Tommaso Carfagno6Giuseppe Battaglia7Pierpaolo Pastina8Pierpaolo Correale9Paolo Tini10Gianluca Pellino11Salvatore Cappabianca12Luigi Pirtoli13Istituto Toscano Tumori, Florence, ItalyDepartment of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, ItalyDepartment of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, ItalyUnit of Medical Imaging, University Hospital of Siena, Siena, ItalyUnit of Medical Imaging, University Hospital of Siena, Siena, ItalyIstituto Toscano Tumori, Florence, ItalyIstituto Toscano Tumori, Florence, ItalyIstituto Toscano Tumori, Florence, ItalyIstituto Toscano Tumori, Florence, ItalyUnit of Medical Oncology, Grand Metropolitan Hospital “Bianchi Melacrino Morelli”, Reggio Calabria, ItalyIstituto Toscano Tumori, Florence, ItalyUnit of Colon-Rectal Surgery, University of Campania “Luigi Vanvitelli”, Naples, ItalyDepartment of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples, ItalyIstituto Toscano Tumori, Florence, ItalyBackground. We hypothesized that texture analysis (TA) from the preoperative MRI can predict early disease progression (ePD), defined as the percentage of patients who relapsed or showed distant metastasis within three months from the radical surgery, in patients with locally advanced rectal cancer (LARC, stage II and III, AJCC) undergoing neoadjuvant chemoradiotherapy (C-RT). Methods. This retrospective monoinstitutional cohort study included 49 consecutive patients in total with a newly diagnosed rectal cancer. All the patients underwent baseline abdominal MRI and CT scan of the chest and abdomen to exclude distant metastasis before C-RT. Texture parameters were extracted from MRI performed before C-RT (T1, DWI, and ADC sequences) using LifeX Software, a dedicated software for extracting texture parameters from radiological imaging. We divided the cohort in a training set of 34 patients and a validation set of 15 patients, and we tested the data sets for homogeneity, considering the clinical variables. Then we performed univariate and multivariate analysis, and a ROC curve was also generated. Results. Thirteen patients (26.5%) showed an ePD, three of whom with lung metastases and ten with liver relapse. The model was validated based on the prediction accuracy calculated in a previously unseen set of 15 patients. The prediction accuracy of the generated model was 82% (AUC=0.853) in the training and 80% (AUC=0.833) in the validation cohort. The only significant features at multivariate analysis was DWI GLCM Correlation (OR: 0.239, p<0.001). Conclusion. Our results suggest that TA could be useful to identify patients that may develop early progression.http://dx.doi.org/10.1155/2019/8505798
spellingShingle Valerio Nardone
Alfonso Reginelli
Fernando Scala
Salvatore Francesco Carbone
Maria Antonietta Mazzei
Lucio Sebaste
Tommaso Carfagno
Giuseppe Battaglia
Pierpaolo Pastina
Pierpaolo Correale
Paolo Tini
Gianluca Pellino
Salvatore Cappabianca
Luigi Pirtoli
Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation
Gastroenterology Research and Practice
title Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation
title_full Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation
title_fullStr Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation
title_full_unstemmed Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation
title_short Magnetic-Resonance-Imaging Texture Analysis Predicts Early Progression in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiation
title_sort magnetic resonance imaging texture analysis predicts early progression in rectal cancer patients undergoing neoadjuvant chemoradiation
url http://dx.doi.org/10.1155/2019/8505798
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