Department of Radiology, Jiangnan University Medical Center, Wuxi, 214000, Jiangsu, China.
Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
BMC Cancer. 2023 Jan 18;23(1):61. doi: 10.1186/s12885-023-10534-w.
Preoperative assessment of lymphovascular invasion(LVI) of rectal cancer has very important clinical significance. However, accurate preoperative imaging evaluation of LVI is highly challenging because the resolution of MRI is still limited. Relatively few studies have focused on prediction of LVI of rectal cancer with the tool of radiomics, especially in patients with negative statue of MRI-based extramural vascular invasion (mrEMVI).The purpose of this study was to explore the preoperative predictive value of biparametric MRI-based radiomics features for LVI of rectal cancer in patients with the negative statue of mrEMVI.
The data of 146 cases of rectal adenocarcinoma confirmed by postoperative pathology were retrospectively collected. In the cases, 38 had positive status of LVI. All patients were examined by MRI before the operation. The biparametric MRI protocols included T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI). We used whole-volume three-dimensional method and two feature selection methods, minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO), to extract and select the features. Logistics regression was used to construct models. The area under the receiver operating characteristic curve (AUC) and DeLong's test were used to evaluate the diagnostic performance of the radiomics based on T2WI and DWI and the combined models.
Radiomics models based on T2WI and DWI had good predictive performance for LVI of rectal cancer in both the training cohort and the validation cohort. The AUCs of the T2WI model were 0.87 and 0.87, and the AUCs of the DWI model were 0.94 and 0.92. The combined model was better than the T2WI model, with AUCs of 0.97 and 0.95. The predictive performance of the DWI model was comparable to that of the combined model.
The radiomics model based on biparametric MRI, especially DWI, had good predictive value for LVI of rectal cancer. This model has the potential to facilitate the clinical recognition of LVI in rectal cancer preoperatively.
术前评估直肠癌的淋巴血管侵犯（LVI）具有非常重要的临床意义。然而，由于 MRI 的分辨率仍然有限，因此准确的术前影像学评估 LVI 极具挑战性。相对较少的研究关注利用放射组学工具预测直肠癌的 LVI，特别是在 MRI 检查结果为阴性的情况下（mrEMVI）。本研究旨在探讨基于双参数 MRI 放射组学特征对 mrEMVI 阴性的直肠癌 LVI 的术前预测价值。
回顾性收集了 146 例经术后病理证实的直肠腺癌病例资料。其中 38 例为 LVI 阳性。所有患者术前均行 MRI 检查。MRI 双参数方案包括 T2 加权成像（T2WI）和弥散加权成像（DWI）。我们使用全容积三维方法和两种特征选择方法（最小冗余最大相关性（mRMR）和最小绝对收缩和选择算子（LASSO））来提取和选择特征。使用逻辑回归构建模型。采用受试者工作特征曲线下面积（AUC）和 DeLong 检验评价基于 T2WI 和 DWI 的放射组学模型和联合模型的诊断性能。
基于 T2WI 和 DWI 的放射组学模型对直肠癌 LVI 的预测性能在训练组和验证组中均较好。T2WI 模型的 AUC 分别为 0.87 和 0.87，DWI 模型的 AUC 分别为 0.94 和 0.92。联合模型优于 T2WI 模型，AUC 分别为 0.97 和 0.95。DWI 模型的预测性能与联合模型相当。
基于双参数 MRI（尤其是 DWI）的放射组学模型对直肠癌的 LVI 具有较好的预测价值。该模型有可能有助于术前临床识别直肠癌的 LVI。
