Rectal cancer response to neoadjuvant chemoradiotherapy evaluated with MRI: Development and validation of a classification algorithm.

Objective: The aim of this study was to develop and validate a decision support model using data mining algorithms, based on morphologic features derived from MRI images, to discriminate between complete responders (CR) and non-complete responders (NCR) patients after neoadjuvant chemoradiotherapy (...

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Publicado en:European Journal of Radiology Vol. 147
Autores principales: Rengo, Marco, Landolfi, Federica, Picchia, Simona, Bellini, Davide, Losquadro, Chiara, Badia, Stefano, Caruso, Damiano, Iannicelli, Elsa, Osti, Mattia Falchetto, Tombolini, Vincenzo, Carbone, Iacopo, Giunta, Gaetano, Laghi, Andrea
Formato: research Journal Article
Publicado: Elsevier B.V. Feb2022
Acceso en línea:Ver este registro en EBSCOhost
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        0720048X
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      jtl: European Journal of Radiology
      issn: 0720048X
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      dt: Feb2022
      vid: 147
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      pub: Elsevier B.V.
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        10.1016/j.ejrad.2021.110146
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        154893459
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        atl: Rectal cancer response to neoadjuvant chemoradiotherapy evaluated with MRI: Development and validation of a classification algorithm.
      aug:
        au:
          Rengo, Marco
          Landolfi, Federica
          Picchia, Simona
          Bellini, Davide
          Losquadro, Chiara
          Badia, Stefano
          Caruso, Damiano
          Iannicelli, Elsa
          Osti, Mattia Falchetto
          Tombolini, Vincenzo
          Carbone, Iacopo
          Giunta, Gaetano
          Laghi, Andrea
        affil: Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Academic Diagnostic imaging Unit, ICOT Hospital, Via Franco Faggiana, 1668. 04100 Latina, Italy
      sug:
        subj:
          Rectal Neoplasms Drug Therapy
          Rectal Neoplasms Therapy
          Neoadjuvant Therapy
          Classification Algorithms
          Treatment Outcomes
          Retrospective Design
          Magnetic Resonance Imaging
          Human
      ab: Objective: The aim of this study was to develop and validate a decision support model using data mining algorithms, based on morphologic features derived from MRI images, to discriminate between complete responders (CR) and non-complete responders (NCR) patients after neoadjuvant chemoradiotherapy (CRT), in a population of patients with locally advanced rectal cancer (LARC).Methods: Two populations were retrospectively enrolled: group A (65 patients) was used to train a data mining decision tree algorithm whereas group B (30 patients) was used to validate it. All patients underwent surgery; according to the histology evaluation, patients were divided in CR and NCR. Staging and restaging MRI examinations were retrospectively analysed and seven parameters were considered for data mining classification. Five different classification methods were tested and evaluated in terms of sensitivity, specificity, accuracy and AUC in order to identify the classification model able to achieve the best performance. The best classification algorithm was subsequently applied to group B for validation: sensitivity, specificity, positive and negative predictive value, accuracy and ROC curve were calculated. Inter and intra-reader agreement were calculated.Results: Four features were selected for the development of the classification algorithm: MRI tumor regression grade (MR-TRG), staging volume (SV), tumor volume reduction rate (TVRR) and signal intensity reduction rate (SIRR). The decision tree J48 showed the highest efficiency: when applied to group B, all the CR and 18/21 NCR were correctly classified (sensitivity 85.71%, specificity 100%, PPV 100%, NPV 94.2%, accuracy 95.7%, AUC 0.833). Both inter- and intra-reader evaluation showed good agreement (κ > 0.6).Conclusions: The proposed decision support model may help in distinguishing between CR and NCR patients with LARC after CRT.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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