Development of a joint prediction model based on both the radiomics and clinical factors for preoperative prediction of circumferential resection margin in middle‐low rectal cancer using T2WI images

Abstract

ObjectivesA circumferential resection margin (CRM) is an independent risk factor for local recurrence, distant metastasis, and poor overall survival of rectal cancer. In this study, we developed and validated a radiomics prediction model to predict perioperative surgical margins in patients with middle and low rectal cancer following neoadjuvant treatment and for decisions about treatment plans for patients.MethodsThis study retrospectively analyzed 275 patients from center 1(training cohort) and 120 patients from center 2(verification cohort) with rectal cancer diagnosed at two centers from July 2020 to July 2022 who underwent neoadjuvant therapy and had their CRM status confirmed by preoperative high‐resolution magnetic resonance imaging (MRI) scans. Radiomics signatures were extracted and screened from MRI images and a radiomics signature was built by the least absolute shrinkage and selection operator (LASSO) logistic regression model, which was combined with clinical signatures to construct a nomogram. The receiver operating characteristic (ROC) curve and area under the curve (AUC) value, sensitivity, specificity, positive predictive value, negative predictive value, and calibration curve were used to evaluate the predictive performance of the model.ResultsIn our research, the combined model has the best performance. In the training group, the radiomics model based on high‐spatial‐resolution T2‐weighted imaging (HR‐T2WI), clinical model and combined model demonstrated an AUC of 0.819 (0.802–0.833), 0.843 (0.822–0.861), and 0.910 (0.880‐0.940), respectively. In the validation group, they demonstrated an AUC of 0.745 (0.715–0.788), 0.827 (0.798–0.850), and 0.848 (0.779‐0.917), respectively. The calibration curve confirmed the clinical applicability of the model.ConclusionsThe individualized prediction model established by combining radiomics signatures and clinical signatures can efficiently and objectively predict perioperative margin invasion in patients with middle and low rectal cancer.

Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy

“…Several models for the prediction of a positive pCRM have been proposed in the literature. Ju et al conducted a retrospective multicentric study on 275 patients with rectal cancers who underwent neoadjuvant therapy, and they investigated the predictive performance of a radiomics prediction model for predicting perioperative surgical margins [29]. This model included both MRI predictors and clinical features, and it achieved an AUC value of 0.848 in the validation stage.…”